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THE 



HOUSEHOLD PHYSICIAN 



FOR THE USE OF 



FAMILIES, PLANTERS, SEAMEN, AND TRAVELLERS. 



BRIEF DESCRIPTION, IN PLAIN LANGUAGE, 



OF ALL THE 



DISEASES OF MEN, WOMEN, AND CHILDREN, 



WITH THE 



NEWEST AND MOST APPROVED METHODS OF CURING THEM. 



BY 

IRA WARREN, A. M., M. D. 

FELLOW OF THE MASSACHUSETTS MEDICAL SOCIETY, ETC. 



IliliUSTBATED 

BY THIRTY-SIX FIGURES ON EIGHT SPLENDID COLORED LITHOGRAPH PLATES, 
AND TWO HUNDRED AND THIRTY-SIX ENGRAVINGS. 



BOSTON: 

HIGGINS, BRADLEY, AND DAYTON, 

20 WASHINGTON STREET. 
1859. , ^ 






Entered, according to Act of Congress, in the year 1859, by 

IRA WARREN, 

In the Clerk's Office of the District Court of the District of Massachusetts 



ELECTROTTPED AND PRINTED BT 
W. F. DRAPER, ANDOVER, MASS. 



PREFACE. 



This book is written for the million. It is based on the assumption 
that every man — the mechanic, the farmer, and the day laborer, as 
well as the professional man — has a right to all the knowledge he is 
capable of acquiring, on all subjects, — medicine not excepted. The 
book aims, therefore, to popularize, and adapt to the many what has 
been claimed as belonging only to the few. 

I do not hesitate to avow that my sympathies, as a man, are with 
the great masses, who may be called the bone and muscle of the race. 
They are, in the main, more shrewd, more endowed with common 
sense, more simple and true in their natural instincts, and conse- 
quently less perverted, than those who claim more refinement, and a 
higher place in the social scale. They are endowed with intellect 
enough to master science, and with sense enough to make a proper 
use of whatever knowledge they may have occasion to acquire. 

" All men," says Hippocrates, one of the great fathers of medicine, 
" ought to be acquainted with the medical art. I believe that knowl- 
edge of medicine is the sister and companion of wisdom." Such 
knowledge would shield the many from the impositions of quaclv|}ry. 
No one, I venture to say, who reads this book thoroughly, will be 
often imposed upon thereafter by quack nostrums, or quack doctors, 
for he will be conscious of knowing more, in most cases, than those 
who seek to make him a victim. Every man's physical organization 
is his own ; and he is charged with the responsibility of taking care 
of it. To do this properly, he needs knowledge of it ; and to with- 
hold this from him, is another form of the old oppression, which de- 
creed knowledge and power to the few, and ignorance and obedience 
to the many. 



IV PREFACE 



In accordance with the design of the work, it has been written in 
plain, simple English, and brought within the compreliension of all 
who have medium powers of mind. It has not been thought needful 
to reduce its language to the simpering style of baby-talk ; that is 
done only by those who don't know much about the people. I believe 
every man who can push a plane, can comprehend good Saxon Eng- 
lish, even when put together in a style sufficiently elevated to please 
scholars. 

In preparing this book, a great number of authors have been care- 
fully consulted, to whom I acknowledge large indebtedness ; yet the 
work is not a mere compilation. With the exception of a few minor 
parts, as those on Hydropathy, the Management of the Sick-Eoom, 
and the Symptoms of Diseases, it has all taken shape, coloring, char- 
acter, and language, in my own mind. In dealing with each disease, 
I have aimed to sketch a brief pen-and-ink portrait, so like it, that 
every reader shall know the original whenever he sees it ; and then 
to give, in the fewest words, the best treatment. 

No work of the sort has ever explained the reasons, or given the 
whys and wherefores of medicine to anything like the extent of this ; 
nor has any one been so extensively illustrated. The engravings 
amount to two hundred and thirty-six in number, and have been, 
with few exceptions, done expressly for this work, in an exceedingly 
neat manner, by Mr. Theodore G. Turner, of Yirginia, now a medi- 
cal student in my office. Of the colored lithographs, there are Thirty- 
six Figures on eight splendid plates. It is enough to say of them that 
they are done, in his best style, by J. H. Bupford, of this city, — 
probably the best lithographer in the country. They are inserted at 
great expense, and add much to the value of the book. 

^I. W. 

No. 3 Avon Place, Boston, 
February, 1859. 



GENERAL INTRODUCTOEY REMARKS. 



Progress of Medicine. 

Medicine may be divided into a science and an art. It is a science 
as it presents facts and evolves principles ; an art as it consists of 
rules for practice. For its present attainments, it is indebted partly 
to researches scientifically conducted, and partly to empyrical and 
hap-hazard discovery. 

As a science, medicine is chiefly indebted, and must ever be, to the 
members of what is called the " regular profession." This body of 
men, while it contains numerous persons whose talents and attain- 
ments do not raise them above the merest quacks, does yet embrace 
large numbers of men who are alike ornaments of the race, and lights 
of their profession. It is to the writings of this class that every stu- 
dent must go who would qualify himself for the proper discharge of 
the duties of a physician ; and he who attempts the practice of medi- 
cine without a knowledge of standard medical writings, is either a 
fool or a knave — either without the brains to understand science, or 
destitute of the honesty to deal fairly with men. 

While this is said, however, it must be granted that a respectable 
portion of the facts which make up the science of medicine, have been 
contributed by the industry of men who have not had what is called 
a regular standing in the profession. I am sorry to be obliged to add 
that the great body of this class have been quacks and charlatans, 
while only a few of them have had talents and acquirements. 

Nevertheless, they have been too indiscriminately condemned. Their 
labors have been useful in various ways, and have contributed to the 
advancement of medical knowledge. A regard for truth, not less than 
justice to these persons, requires this statement. 

One Idea Men. — The " irregulars," as they have been called, have 
generally had their hobbies, which they have ridden with singular 
diligence, and often in little better than John Gilpin plight. Yet they 
have drawn attention to great truths, which the regular profession 
either did not see, or would not commend ; and they have done this 
by dwelling incessantly upon some single idea. 

The one idea men, of every class, have been ridiculed in all ages ; 
and indeed have always exhibited some singular obliquities. Yet 
when they have been men of learning and talents, they have accom- 
plished great things, either for good or evil. 



GENERAL INTRODUCTORY REMARKS. 



Martin Luther was strictly a one-idea man. The whole force of his 
extraordinary character was given to the propagation of the single 
doctrine of justification by faith ; and by the incessant efforts he made 
for this purpose, he sank the doctrine deeper into the heart of Europe 
than a hundred equally powerful men could have done by giving it 
only an ordinary share of attention. 

William Ellery Channing was a one-ideaist. Man^ the noblest 
work of creation, to be developed, educated, adorned, loved, made like 
unto God, was the thought of his life — a thought which he embel- 
lished and moulded into all the forms of beauty which our flexible 
language is capable of producing. Under the mild promptings of his 
genius, and the workings of this thought, philanthropy, quickened into 
a new life, spread out her arms, and embraced the world. 

Sir Isaac Newton was a one-ideaist. So entirely did he devote his 
great powers to astronomy and the higher mathematics, that he be- 
came unfitted for the duties of social and domestic life — so unfitted, 
that when induced by his friends to give a little attention to courtship, 
he fell into one of his abstractions, and detected himself in using his 
lady-love's fore finger to poke down the ashes in his pipe I But Sir 
Isaac advanced mathematical science to a point far beyond its previ- 
ous attainments, and laid it under such obligations as no general 
scholar could have done. 

It is in this way, though in a vastly less degree, and without the 
scientific method, that one-ideaists in medicine benefit the world. 
They seize upon some single remedy, — generally one which has been 
overlooked, — and using it themselves to the exclusion of all others, 
they press it upon the world as the panacea for all its ills. With 
them disease is a unit, and they have found its one all-important 
remedy. Thus convinced, they press it upon others with the enthu- 
siasm of fanatics. Testing it in all cases, they develop all its virtues. 
Those who have the good sense to turn their attention to it, have 
only to use it in those cases for which its adaptation is proved. 

It is in this way that these men become, incidentally, medical dis- 
coverers ; and not being burdened with modesty, they never withhold 
their importunities till the world acknowledges whatever value there 
is in their discovery. And although they may do some mischief with 
the single-edged tool which they handle so industriously, I doubt if 
they do much more than many better workmen who use too many. 
At all events, wise and generous men thank them for their gift to the 
profession, smaU though it may be, and use it in the light of a clearer 
knowledge. 



'&' 



Hydropathy. — As an illustration of what I have just been saying, 
I may refer to hydropathy, or the plan of treating all diseases by 
water. 

The singularly careful avoidance, by the whole medical faculty, for 
many ages, of the article of pure water as a medicinal, or rather, 
health-imparting agent, was anything but creditable to the profession. 

It is now admitted by all sensible men that water, cold and warm, 
used at proper times and to a reasonable extent, has great power over 



GENERAL INTRODUCTORY REMARKS. 



several diseases, and is a powerful promoter of health. No physicians, 
except those who are too indolent to know what is going on in the 
world, or too fast locked in old prejudices to touch new things, now 
omit its use in many cases. How warm and sincere my own approval 
of water as a remedy is, almost every page of this volume will attest. 
Indeed it may honestly be allowed that the hydropathists have fairly 
drowned the almost criminal professional prejudice against water. 
They are in all the more need of this concession, since in their absurd 
zeal to cure all diseases by water, and make aquatic animals of men, 
they have also drowned their own common sense. 

Homoeopathy. — There is a class of diseases called nervous, over 
which medicine frequently has little or no control. In these cases, 
and also in those disorders which are not yet fully understood, and 
over which the empire of medicine is not settled, the homoeopathist 
steps in, and seizing upon the imagination, and wielding its powers 
on the side of nature's restorative efforts, often shows results which 
look like singular success. In fact this class of practitioners are in- 
direct experimenters upon the imagination. They are therefore use- 
ful members of the profession. 

Let me be understood. I will not say, because it would not be just 
to say, that the whole success of this class of practitioners is to be 
traced to the powers of the imagination. They give great attention 
to exercise, diet, the use of water, etc., — things which contribute very 
powerfully to preserve health, and to restore it when lost. In this 
thing, the old school practitioners ought to learn a most important 
lesson from them. In truth, they are learning it, but very slowly and 
reluctantly^ I am sorry to say. 

The central idea of the homoeopathist, that 'like cures like," the 
" great law of cure," as he styles it, I do not feel called upon to dis- 
cuss — theories being of much less consequence than rules of practice. 
The old school men have certainly much to learn from him respecting 
the augmented power of medicine from the greatest possible division 
by trituration. We have learned from him, too, — though many are 
too ungenerous to confess the source of the information, — that we 
may gain our purposes with much less medicine than we were once 
in the habit of giving. 

Eclectics. — There is a large and growing class of physicians, called, 
at first, after the founder of the school, Thomsonians. Subsequently, 
they were generally known as Botanic Physicians. .Now they pass 
under the title of Eclectics. 

These men, directing their attention, at first, chiefly to cayenne and 
lobelia, have gradually extended their zealous researches over the veg- 
etable kingdom, and have gathered much information worthy to be 
preserved. These researches have revealed a sadly neglected duty 
on the part of old school practitioners, and, in 185:2, drew from the 
" Committee on Indigenous Medical Botany," a})pointed by the "Amer- 
ican Medical Association," the confession that our practitioners gen- 
erally have been extremely ignorant of the medicinal plants even in 
their own neighborhoods ; and to this fact the committee attributed 



8 GENERAL INTRODUCTORY REMARKS. 

it, that the Eclectic physicians had in so many instances supplanted 
the " regulars " in the confidence of the people. 

The education and talents of this class of practitioners have gradu- 
ally risen, year by year, until they have several medical schools, where 
students are well instructed in the principles of medicine, by men of 
real ability. This is particularly true of the school at Cincinnati. 
They have also a literature of no mean significance, especially in 
the department of materia medica. The list of remedies they have 
given to the world, drawn from our home plants, are a boon of no 
small value. I regard them as equal in value to all we were pre- 
viously in possession of from the vegetable kingdom. Thepodophyllin 
and leptandrin, as substitutes, in most cases, for mercurials, can hardly 
be too highly prized. 

And yet, it is mortifying that the remedies which these men have 
given us, are, by hundreds of our old school practitioners, not even 
known by name, and where known, generally not honored with a trial. 
King's " American Eclectic Dispensatory," a book of 1300 pages, in 
which they are well described, is almost unknown among us. Aside 
from the copy in my own library, I do not know that one is owned by 
any member of the Massachusetts Medical Society in Boston. I con- 
sider this a disgrace, for however learned a man may be, he is not 
fully equipped as a practitioner, until he is acquainted with this class 
of medicines. 

Physiologists. — Beside these various direct practitioners of medi- 
cine, there is the large and quite intelligent class of physiologists, in- 
cluding the phrenologists, who nearly discard medicine, and, appealing 
to the laws of life established by the Creator, urge temperance in eat- 
ing and drinking; exercise in the open air; securing of pure air by 
ventilating dwellings, school-houses, and churches ; bathing ia cold 
and warm water ; cheerfulness of mind ; and the cultivation of the 
Christian virtues, as the only rational modes of securing health and 
life. 

I confess myself inclined to forgive this class their error in banishing 
medicine, in view of their zeal and success in disseminating hygienic 
information of the utmost value and importance to mankind. Put 
man into harmony with nature, and establish over him the empire of 
reason, and their theory would be excellent ; but as things are, medi- 
cines, like prisons, and alms-houses, and large cities, are " necessary 
evils." 

Other Practitioners. — Finally, we have Mesmerists, Pathetists, 
Electro-biologists, Spiritualists, Nutritivists, and what not, all pre- 
tending to cure disease by processes peculiar to themselves. They 
are all experimenters in dift'erent departments of nature, — now spread- 
ing over our eyes a large plaster of humbuggery, and now drawing a 
small curtain and giving us a peep into the large and well-furnished 
rooms which nature has fitted up for our reception, by and by, when 
we are better instructed. 

All Useful in a Deo-ree. — On the whole, T am disposed to regard 
all the operators in the different departments of medicine as useful 



GENERAL INTRODUCTORY REMARKS. 



in their degree; excepting always those mercenary quacks, who lie 
about their remedies to make money. Each of all these (I mean all 
sincere and true men who believe what they teach), is aiding in some 
measure the general advancement. And though the truths, as they 
gather and present them, are but fragmentary, they are useful in the 
hands of those true Eclectics^ who have the wisdom and independence 
to select the best things out of all systems. 

General Conclusion. — This brings me to remark that there is but 
one truly liberal and philosophical school of medicine. It is the 
Eclectic. — composed of those who have liberality enough to reject 
every exclusive system^ and to select out of all systems those things 
which are approved by experience and reason. 

I have already spoken of a school of practitioners called Eclectic. 
To a certain extent they are entitled to the name, but I think not 
entirely. ' They have formed a separate and exclusive school. They 
have turned some articles out of the materia medica possibly for no 
better reason than because their party is committed to their rejection; 
whereas they should have no party, but allow each man to act as if 
he were a citizen of the world only, and not a member of any re- 
stricted association. But I will not quarrel with them on this point. 
I think they are becoming eclectic. 

ProgTess of Medicine. — There have been long periods when the 
science and the art of medicine made scarcely any progress. They 
are now advancing, — in some departments quite fast. 

The Chemistry of Man, commonly called Animal Chemistry, is 
opening new sources of light. Few of the profession have yet 
studied this essential branch of medical science ; but the delinquents 
are sleeping in the rear, and will soon awake to find themselves among 
the ghosts of a dead generation. 

The writer was in the habit of asserting, many years ago, that most 
of the true progress in medicine must come through Animal Chem- 
istry ; and the developments of the last few years have made good the 
assertion. Liebig, a diligent student in chemistry, has done much to 
open the way for inquirers in this department. Simon has perhaps 
done more. Mialhe is a yet later explorer, and has made valuable 
discoveries. 

The result is, that students have now before their minds, and are 
endeavoring to solve and act upon as fast as possible, inquiries and 
propositions like these : 

What is the chemical composition of the solids and fluids of the 
healthy human body ? 

What is the nature of the changes which occur in the composition 
of the solids and fluids during disease ? 

What alterations in the chemical composition of the solids and 
fluids take place during the operation of medicines ? 

Before it can exert any remote action on the animal economy, a 
remedy must be absorbed. 

Before it can be absorbed, it must be soluble in the fluids oi the 
living body. 

2 



10 ' GENERAL INTRODUCTORY REMARKS. 

Medicines are subject to chemical changes during their passage 
through the system. 

These changes are regulated by ordinary chemical laws, and may 
therefore, to some extent, be foretold and made available in the cure 
of disease. 

These chemical laws are disturbed and varied, to some extent, by 
the law of vitality, — just as the needle is made to vary by disturbing 
forces. 

What are those disturbances, and to what extent, and under what 
circumstances, do they occur ? 

With these and similar inquiries and propositions before his mind, 
diligently studied, a man will in time learn to prescribe with some 
intelligent aim. He will not know everything, to be sure, but what 
he does know, he will have a reason for knowing. If he give a medi- 
cine, he will have in view the chemical changes of the solids and fluids 
of the body, known to be produced by the disease he is combatting. 
He will also keep in mind the solution of the medicine in the fluids 
of the body, and the chemical reaction between its components and 
the acids, alkalies, etc., found in the alimentary tube and elsewhere. 

As the science of medicine advances, and becomes liberal and 
eclectic in its character, gathering from all systems the best attested 
facts, and using them to the exclusion of all mere theories, these facts 
must not themselves degenerate into mere petted theories, but must 
be held in subordination to future experience. Medical practitioners, 
who would meet the wants of the age, must be men of progress. The 
light of to-morrow, with them,, must modify and improve the light of 
to-day. They must knock, every hour, for admission into some new 
apartment of nature. 

Need of Liberality. — That medical progress may be real, physicians 
must be free from bigotry. They must have no narrow prejudices 
against any man, or class of men ; but be ready to examine candidly 
any new thought or new remedy brought to their notice, from what- 
ever source it may come. 

They should not hedge themselves about with such restrictive by- 
laws and societary rules as are calculated to fetter their thoughts, and 
turn their investigations, by a sort of moral necessity, into the narrow 
channels of party conservatism; remembering that he who is once 
enclosed by such restrictions, must hew a path for his feet through 
bigotry, and even malevolence itself, before he can escape them, or be 
a free man in any noble sense. 

The members of medical societies do themselves no credit, in the 
nineteenth century, by putting on airs, and telling others to stand at 
a distance. This would do better, had medicine become an exact 
science ; but while the primary effects of even opium are not settled — 
some physicians considering it as primarily stimulant, others as seda- 
tive, others as stimulant to the nerves and sedative to the muscles, oth- 
ers as neither, and still others as alterative, — such exclusiveness seems 
neither wise nor modest. When the professors of the healing art can 
hoard medical knowledge as misers hoard gold, and can submit its 



GENEKAL INTRODUCTORY REMARKS. 11 

purity to equally certain tests, it will appear in better taste for them to 
grow exclusive. Until then, the most becoming badge they can wear 
is the Christian direction : " Let each esteem others better than him- 
self." 

Medical societies, with liberal by-laws, are fitted to do good ; but it 
would be hard to show that those with stringently-restrictive rules 
can operate otherwise than as checks upon progress. In truth, they 
are apt to become mere catacombs in which to embalm dead ideas. 
They are very liable to be made the instruments for accomplishing 
the ambitious purposes of a few leading men. They tend to suppress 
all sympathy with everything outside their organization ; and they 
beget a feeling like that which would forbid the fixed stars to drop 
their light into our atmosphere without first coming down and joining 
the solar system. 

Conservative Leaders. — There are no influences which hold so 
steady a check upon medical progress as the conservative leaders in 
many of our medical associations. Not that they are opposed to im- 
provement in the medical art, or would object to any amount of dis- 
covery, if it could come to the profession through channels which they 
have the honor of opening. But against all light from outside, or from 
obscure sources, they will draw down the curtains, and close the 
doors ; and if it chance by any means, in spite of them, to get within 
the sacred enclosure, they will call it darkness, and, as priests of the 
temple, will attempt to atone for the indignity offered to the god of 
medicine, and fill the whole sky with murky clouds from their altars. 

These men have strong faith in caste, and in the right of the few 
to govern the many. In the low places of society, they look for noth- 
ing but ignorance and poverty. Notwithstanding that the light of 
every natural day breaks in the horizon, and ascends^ ^^^y so far des- 
pise analogies as to insist that all medical light breaks at wiiat they 
call the zenith of the profession, and comes doavn. With them the 
temples of Esculapius are all rebuilt, and they are the priests ; and to 
ofler in sacrifice the smallest medicinal plant is a sacrilege, unless it 
be entrusted to their hands. 

Such persons measure and weigh a man by the amount of money 
he has. Property is their god, which gives laws to everything. With 
them, knowledge, like property, goes to posterity by will, — they being 
the principal testators. Like their money, too, it goes chiefly to their 
sons, and tp certain favored institutions, by whom, and in which, it is 
to be hoarded, and whence it is to go out only in certain approved 
channels, weighed and stamped, like coin from the mint. 

These are the men who regard knowledge as a contraband article, 
unless regularly entered at the custom-house, with bills of lading prop- 
erly certified by the conservative magnates at some other metropolis. 
With them, knowledge is not like the west wind, fanning the brow 
of the peasant as gently as that of the king, — not like the light of 
heaven, entering the small, clean window of the hut, as readily as the 
larger one of the palace ; not a boon which comes alike freely to all, 
and which is to be everywhere amplified, changed as circumstances 



12 GENER^VL INTRODUCTORY REMARKS. 

and conditions require, and especially adapted to the present hour. 
Jt is rather, as they too often view it, like lithographed letters of advice, 
printed upon stamp paper, and carefully sealed up and addressed to 
posterity. And then, if they can be made the mail-carriers, and be 
permitted to pass, unchallenged, with the precious bag, from post to 
post, and pass it over, carefully sealed, to the next generation, they 
will think it has done its work, and that they have fulfilled their mis- 
sion. 

I would not be unjust or severe, but I cannot but remark further, 
that these men present but one view of humanity. They are monoto- 
nous objects of inspection. Look at them a thousand times, and you see 
only the same unaltered phase of life. To the mariner on life's ocean, 
they are not safe lights. If he approach them on the dark side, they 
remain black as night to him, until he comes round to their shining 
front. They are not revolving lights. They have light ; it may be 
bright and genial ; but it gleams out upon the waters only in one 
direction. It does not sweep round, and throw its rays upon every 
mariner's path. 

Such men are useful, but only to a certain class. They have in them 
no true omnilog'T/ — they are not all-teaching'. Their lives are instruc- 
tive to their friends, their clique, their party, their school ; but a stum- 
bling-block, a hindrance, an oppression, an offence to everybody else. 
They are like porcupines, with fronts smooth and easy of access ; but 
their backs bristle with quills to stick into those on the wrong side. 
They are not whole men. Humanity has infused into them only one 
or two of its elements. They have length, but no breadth. They are 
citizens of Boston, New York, Philadelphia, or Cincinnati, but not of 
the world. Within certain circles, they are genial friends, but cynics 
and haters outside of them. From their high places, they come down 
to their humble followers with tokens of friendly recognition ; upon 
others they frown and lower like armed castles. 

The True Physician, — How different the character of the true man 
and physician I He is genial in his disposition. He has no dislikes 
and antipathies, and hates no men except tyrants. He accepts knowl- 
edge, though it come from the humblest source ; believing there is no 
experience but will repay a study of it, and no husbandman's plough- 
share but turns up a soil worth analyzing. He belongs exclusively to 
no party, and can be approached easily by respectable men of every 
stamp. Whether belonging to the same society with him or not, you 
may take hold of his nature and draw it out, without having it slip 
from your fingers, and spring back from your presence into a thousand 
kinks, like an overtAvisted thread. He is a whole man. God made 
him for the world, and not for a party. By some strong influence 
you may possibly, for a time, draw him from the world into some 
narrower sphere, but not only will his reluctant nature, like a retiring 
tide, run back continually to embrace the continent, but will soon 
break from its confinement, and like a full sea, come back, boiling and 
running over. 

What is now Wanted. — The foregoing remarks indicate one great, 



GENERAL INTRODUCTORY REMARKS. l:i 

leading want, in order that medical knowledge may increase. It is 
liberality^ in the true and full sense. We want true men in high 
places, who will not only let their own lig'ht shine everywhere^ but vnll 
cease to hinder other merHs li^htfrom shining. 

Beyond this, and of nearly equal importance with it, vw vmnt medi- 
cal knowledge diffused among the 'people. We want, — what the world 
has never seen, — a popular medical literature. We want the temples 
of Esculapius pulled down, and the priests turned into the streets to 
become teachers of the multitude, rather than worshippers in the 
inner sanctuary. 

I know this want will be stoutly denied, but not, I think, on well- 
considered grounds. We do not think it necessary to confine a knowl- 
edge of the soul to the ministers of religion. There is no branch of 
theology which we do not deem it proper for laymen to study ; we 
even popularize it for our children. In the obscurest towns of New 
England', laymen who follow the plough or push the plane, become, 
in many cases, eminent theologians. Why should they not study 
the lower science which relates to the body ? They have not been 
able to heretofore, because its mysteries have been purposely hidden 
under technicalities. These coverings should be torn off. 

It is said that those who begin to read upon medicine are very apt 
to imagine themselves afflicted with the various symptoms they find 
described. To some small extent this is true ; but it is also true that 
the light they obtain relieves them from many apprehensions which 
their previous ignorance allowed to prey upon them ; as boys lose 
their fears when the light of the morning changes to some familiar 
object the ghost of the preceding night. 

Physicians oppose the popularizing of this kind of knowledge too 
often, I fear, upon the sordid ground of self-interest. They think their 
own services will be less sought. 

We do not dispense with the services of ministers because the 
people study theology, neither shall we cease to employ teachers and 
practitioners of medicine when each man and woman is wise enough 
to study the healing art. The principal change we shall witness will 
be much larger attainments in knowledge among practitioners, — just 
as the ministers of religion now know, and are obliged to know, ten 
times as much as in those darker periods when the people received all 
spiritual knowledge from their mouths. The teachers of any art or 
science are obliged to keep in advance of their pupils. Let medicine 
become a popular study, and we shall have very few ignorant physi- 
cians, and quackery will become one of the impossibilities. Homce- 
opathists. Eclectics, Hydropathists, and Physiologists, believe in scat- 
tering medical books, stripped of their technicalities, among the 
multitude, and their people purchase very few secret, advertised medi- 
cines; — these being chiefly bought and consumed by the followers of 
those who believe this kind of reading fosters quackery I 



^iT^TOM Y 



Anatomy describes the structure and organization of living beings. 

Special Anatomy treats of the weight, size, shape, color, etc., of 
each organ separately. 

General Anatomy investigates the tissues or structures from which 
organs are formed. 

Surgical Anatomy or Regional Anatomy considers the relations of 
organs to one another. 

Physiological Anatomy treats of the uses or functions of organs in 
health. 

Pathological Anatomy describes the alterations made upon different 
organs by disease. 

We shall here introduce a very brief compendium only of Special 
Anatomy. 

It is of great consequence that every person should have some 
knowledge of anatomy and physiology. Self-knowledge ought to 
extend to the body as well as the mind. To know one's self, physi- 
cally, is to gain a new insight into that wonderfully skilful adjustment 
of means to ends- which is never absent from the works of God. 
Without this knowledge, one cannot know how to take care of the 
health ; and without health, life loses most of its value. 

Structure of the Body. 

The human body is composed of solids and fluids. 

The fluids are most abundant in children and youth. It is this 
which gives softness and pliancy to their flesh. In old age the fluids 
are less abundant, and the flesh is more hard and wrinkled. 

The fluids contain the whole body, as it were, in a state of solution; 
or rather, they hold the materials out of which it is manufactured. 

Chemical Properties of the Body. 

The four elements, oxygen, hydrogen, carbon, and nitrogen, make 
up nearly the whole bulk of the fluids and soft solids of the human 
body. A number of other elements, chiefly in a state of combination, 
and in much smaller quantities, enter into several of the tissues. 

Binary Coinpouuds. — Thus, we have carbonic acid in blood, urine, 



ANATOMY. 15 



and sweat; and we have water universally diffused through the sys- 
tem, — each of these substances being a binary compound, that is, 
composed of two elements. 

Compounds of more than two Elements, are widely distributed over 
the body ; as, 

Carbonate of Soda in serum, saliva, bile, mucus, sweaf, and tears. 

Carbonate of Lime in cartilage, bone, and teeth. 

Phosphate of Lime in bones, teeth, and cartilage. 

Phosphate of Iron in blood, gastric juice, and urine. 

Chloride of Sodium in blood, brain, muscle, bone, cartilage and pig- 
ment. 

Chloride of Potassium in blood, gastric juice, milk, and saliva. 

Chloride of Calcium in gastric juice. 

Sulphate of Potassa in urine, gastric juice, and cartilage. 

Sulphate of Soda in sweat, bile, and cartilage. 

Sulphate of Lime in bile, hair, and scarf-skin. 

Oxide of Iron in blood, black pigment, and hair. 

Org'anized Compounds. — Beside the above inorganic elements and 
compounds, several organized substances, or proximate elements^ as 
they are called, exist largely in the body. The chief of these are 
albumen, fibrine, gelatine, mucus, fat, caseine, and osmazome. Oth- 
ers need not be named. 

Albumen is found in great abundance in the human body. It is 
the raw material out of which the flesh and other tissues are made. 
The white of an eg^^ which is nearly pure albumen, is a good speci- 
men of it. 

Fibiine, when removed from the human body, changes from a solu- 
ble to an insoluble state. In other words, it coagulates in a kind 
of net-work. Nearly the same thing takes place constantly in the 
living body, when the liquid fibrine leaves its soluble state, and is 
deposited as solid flesh. Fibrine bears the same relation to albumen 
that woollen yarn does to wool ; it is spun from it in the busy wheel 
of organic life. And the flesh or muscle is related to fibrine as the 
cloth is to yarn ; it is woven from it in the vital loom. Fibrine has 
been called liquid flesh. 

Gelatine exists largely in the ligaments, cartilages, bones, skin, and 
cellular tissue. When dissolved, five parts in one hundred of hot 
water, it forms a thick jelly. Isinglass is a form of gelatine obtained 
from the air-bladder of the sturgeon and the cod-fish. Glue is still 
another form of gelatine. It is extracted from the bones, and parings 
of hides, and the hoofs and ears of cattle, by boiling in water. Black 
silk, varnished over with a solution of gelatine, forms court-plaster. 

Mucus is a sticky fluid secreted by the gland-cells. It is spread 
over the surface of the mucous membranes, and serves to moisten and 
defend them from injury. 

Fat consists of cells held together by cellular tissue and vessels, and 
contains glycerine, stearic acid, margaric acid, and elaic acid. It has 



16 ANATOMY. 



no nitrogen. If the stearic acid be in excess, the fat is hard ; if the 
elaic acid preponderate, it is soft. The stearine extracted from fat, 
is used for making very hard candles. 

Caseine is abundant in milk and constitutes its curd. It is held in 
solution in milk by a little soda. When dried, it is cheese. It is 
found in blood, saliva, bile, and the lens of the eye. It forms the 
chief nourishment of those young animals which live on milk. It 
is found in peas, beans, and lentils. Vegetable and animal caseine 
are precisely alike in all their properties. Fibrine and albumen con- 
tain almost exactly the same amount of oxygen, hydrogen, carbon, 
nitrogen, and sulphur, which is found in caseine. This latter, when 
taken into the stomach, therefore, goes, without much change, to the 
formation of the albumen and fibrine of the body. 

Physical Properties of the Body. 

Tlie Tissues. — The solid organized substances of which the human 
body is composed, are called tissues. There are various kinds of 
tissues. 

The Cellular Tissue, commonly called areolar, is made up of small 
fibres and bands woven together into a sort of net-work, with numer- 
ous little spaces opening into each other. These spaces are filled with 
a watery fluid ; and when this is greatly increased by disease, so as 
to cause the parts to swell, and the skin to shine, the person has ana- 
sarca, or cell dropsy. The uses of this tissue are to give parts and 
organs a kind of elastic cushion to rest upon, so that they may not be 
bruised and injured by the shocks of life; to make a kind of safe high- 
way for delicate vessels to pass from one part of the body to another ; 
and to furnish a beautifully arranged lodgement for the watery fluid 
which gives such roundness, smoothness, and grace to the human 
form. The opening of the cells into each other explains the reason 
why feeble persons have swelled feet and ankles in the evening, and 
not in the morning, — the fluid settling down from cell to cell, into 
the lowest parts, while they are up during the day, and rurming back 
to its proper place while they are lying down during the night. 

Tlie Mucous Tissue, or mucous 7nembrane, lines all the cavities which 
communicate with the air, as the mouth, stomach, bowels, lungs, etc. 
It is supplied with numerous small glands which secrete a ^ticky kind 
of fluid called mucus, to protect the surface from any injury which 
might be inflicted by air, or by irritating substances suspended in it. 

Tlie Serous Tissue, or me^nbrane, lines all the cavities which do not 
communicate with the air, that is, all those which are shut, and have 
no outward opening. The skull, the chest, and the belly are lined by 
this kind of membrane. The membrane itself forms the closed sack, 
— one layer of it being attached to the cavity H lines, while the other 
is folded back upon and around the contents of the cavity, which are 
left outside of the sack. A watery fluid oozes from the inner surface 
of the sack, to make its sides glide easily upon each other. When 



ANATOMY. 17 



some disease causes this water to be poured out too freely, so as to 
fill, or partly fill the cavity, we have dropsy of the brain, or chest, or 
belly, as the case may be. 

The Dermoid Tissue covers the whole outside of the body. We 
call it the skin^ or cutis. It is similar in structure to the mucous mem- 
branes, which are a mere continuation of it. It is harder than the 
mucous membrane, because more exposed to injury. In health, it 
never ceases to secrete and throw off a fluid which we call insensible 
perspiration while it is in the form of an invisible vapor, and perspira- 
tion, or sweat, when it is so increased as to be seen. So great is the 
sympathy between this dermoid covering of the body and the mucous 
membranes, that when it is chilled so as to stop the invisible perspira- 
tion, the internal membrane becomes affected, and we have a sore 
throat, or diarrhoea, or running at the nose ; that is to say, when the 
skin cannot sweat, the mucous membrane begins to sweat. 

The Fibrous Tissue consists of closely united fibres, and for what- 
ever purpose used, forms a fine, dense, and enduring body. In some 
cases it takes the form of a membrane, as the dura mater, which lines 
the interior of the skull and spinal column. The ligaments which hold 
the 'bones together, and the tendons or cords, which fasten the muscles 
to the bones, are fibrous bodies. It is this firm substance of which 
rheumatism frequently takes hold, and this is the reason why it lingers 
so much about the joints. It sometimes takes hold of the ligament 
which fastens the deltoid muscle to the bone of the upper arm, about 
two-thirds of the way from the elbow to the shoulder. This muscle 
lifts up the arm. In this form of rheumatism, therefore, the arm hangs 
helpless at the side. 

Tlie Cartilaginous Tissue covers the ends of the bones where they 
come together to make a joint. It is well fitted to make the joint 
work easy, being smooth, hard, and elastic. 

The Osseous or Bony Tissue varies in its composition, density, and 
strength, according to the age of the person, and the uses of the bone. 

The Muscular Tissue, or muscle, being made for a great deal of 
Fig. 1. pulling and lifting, is formed some- 

thing like a rope, except that there 
is no twisting. Many small fibres, or 
filaments unite to form fasciculi. A 
fasciculus is a bundle of fibres sur- 
rounded by a delicate layer of cell 
tissue called sarcolemma, — just as a 
cord is a number of smaller threads 
of cotton or hemp bound together. A 
number of these fasciculi united to- 
gether, make a muscle, — just as sev- 
eral chords, called strands, twisted to- 
gether, make a rope. Figure \ gives us a good view of the fibres and 
bundles, highly magnified. 




18 ANATOMY. 



Tlie Adipose Tissue is the material which the human body works 
up into pots and cells containing fat. It is found chiefly under the 
skin and muscles of the belly, and around the heart and kidneys. 
By the increase of this tissue, persons may become enormously en- 
larged without having their muscles at all increased in size. Such a 
condition is to be deplored, — the body having become merely the 
store-house or depot of myriads of pots of fat. 

The jVervoiis Tissue is composed of two distinct kinds of matter, 
— the one gray and pulpy, called cineritious, the other while and 
fibrous, called medullary. The external part of the brain and the in- 
ternal portion of the spinal cord are composed of the gray or ash- 
colored tissue ; the nerves are made only of the white or fibrous matter, 
and are inclosed in a delicate sheath called neurilemma. 



Vital Properties of the Body. 

Bodies begin their growth with a simple cell^ which is a delicate 
little bladder or shut sack. Cells take their rise in that portion of the 
blood which is capable of being organized^ and which is called blas- 
tema. 

In animal bodies, each cell generally begins as a minute point in 
the blastema, and grows until a transparent bladder or vesicle springs 
out from one side of it, and soon appears to enclose it. The bladder 
is then called the cell, and the point or dot is its nucleus. Within this 
nucleus appears another dot, which is called the nucleolus. When 
fully ripened, the cell bursts and sets the nucleus free, and this, in its 
turn, matures and yields up its contents. Thus all cells have their 
origin in germs produced by previously existing parent cells. They 
are multiplied with great rapidity. Having grown to a certain extent, 
they lose their fluid contents, and their walls collapsing or coming to- 
gether, they form simple membranous discs. In this way, with some 
variations, the simple tissues of the body begin to be, and the founda- 
tion is laid for the noble structure of man. 



Anatomy of the Bones. 

The human skeleton is composed of two hundred and eight bones, 
the teeth not included. 

When fastened together by natural ligaments, the bones are said 
to form a natural skeleton ; when attached by wires, an artificial skele- 
ton. 

In Figure 2, — 1, 1, represent the spinal column ; 2, the skull ; 3, 
the lower jaw ; 4, the breast bone (sternum) ; 6, the ribs ; 7, the col- 
lar bone ; 8, the bone of the upper arm (humerus) ; 9, the shoulder 
joint; 10, the radius; 11, the ulna; 12, the elbow joint; 13, the wrist; 
14, the hand; 15, the haunch bone; 16, the sacrum; 17, the hip joint; 
18, the thigh bone ; 19, the knee cap (patella) ; 20, the knee joint ; 
21, the fibiiia; 22, the tibia; 23, ankle joint; 24, the foot; 27, 28, 29, 



ANATOMY. 



19 



the ligaments of the shoulder, elbow, and wrist ; 30, the large artery 
of the arm ; 31, the ligaments of the hip joint ; 32, the large blood 
vessels of the thigh; 33, the artery of the leg; 34, 35, 36, the liga- 



ments of the knee cap, knee, and ankle. 



Fig. 2. 




The protuberances or swellings in certain parts of bones are called 
processes, and are the points to which muscles and ligaments are 
fastened. 

The bones are supplied with nutritive vessels, and, like other parts 
of the body, are formed from the blood. At first they are compara- 
tively soft, and cartilagenous. After a time, in the young animal, 
they begin to change to bone at certain places, called points of ossifi- 
cation. They are covered with a strong fibrous membrane called the 
periosteum. A somewhat similar covering upon the cartilages has the 
name oi perichondrium, and that which covers the skull is X\\c pericra- 
nium. 

The bones are compounded of earthy and animal matter. From 



20 



ANATOMY. 



the former, — phosphate and carbonate of lime, — they receive their 
strength ; ifrom the latter, — cartilage, — they derive their life. 

Put a bone for a few days into diluted muriatic acid, — one part of 
acid to six of water, — and the phosphate and carbonate of lime will 
all be removed, while the bone will remain the same in shape. It 
^^o-3- will now be comparatively 

soft, and may be bent, or 
even tied into a knot, with- 
out breaking. Place a simi- 
lar bone in the fire for a few 
hours, and it will also retain 
its shape, but the cartilagi- 
nous portion will be gone. 
It is now brittle, and may be 
picked in pieces with the fin- 
gers. 

The bones are divided into those of the head, thirty ; of the body, 
fifty-four; of the upper limbs, sixty-four; and of the lower limbs, 
sixty. 




Bones of the Head. 



Fig. 4. 



The bones of the head are divided into those of the skull^ the ear^ 
and the face. 

The skull has eight bones. They are composed of two plates, 
one above the other, with a porous partition between. These two 
plates are capable of giving the brain very powerful protection against 
injury, the outer one being fibrous and toiig-Jiy — the inner one, hard 
and glass-like^ and hence called vitreous. 

The middle layer has the name of diploe. Its spongy nature deadens 
the jar from a blow inflicted upon the outer table. In early life, when 
the bones are tender and yielding, this porous layer is not needed, 
and is not found. 

That the bones of the skull may not 
easily slip by each other, and get out 
of place, they are dovetailed together in 
curious lines called sutures. In advanced 
years, these generally close up, the bones 
uniting firmly together. In early life 
they are quite open, the firm bones not 
covering the whole brain. The opening 
of the coronal suture in childhood is called 
a fontanelle. It presents a soft place up- 
on the top of the head, where the finger 
could be pressed down into the brain. In 
Figure 4, — 1, 1, show the coronal suture 
on the front and upper part of the skull ; 2, 
the sagittal suture on the top of the skull ; 
and 3, 3, the lambdoidal suture, running down on each side of the 
back part of the skull. 




ANATOMY 



21 



Fig. 5. 




Figure 5 shows the skull bones separated from each other at the 

sutures : 1, the frontal 
bone ; 2, the parietal ; 
3, the occipital ; 4, the 
temporal ; 5, the nasal ; 
6, the malar; 7, the su- 
perior maxillary ; 8, the 
unguis ; 9, the inferior 
maxillary. Arnott has 
demonstrated that the 
form of the skull is the 
best possible for sustain- 
ing weights, and resist- 
ing blows. The summit 
of the head is a complete 
arch, like that of a bridge. 
The ear has four small 
bones, which aid the 
sense of hearing. 

The bones of the face 

are fourteen in number. They hold the soft parts in place, and aid in 

grinding the food. 

Bones of the Trunk. 

In the trunk there are twenty-four ribs ; twenty-four pieces in the 
back bone or spinal column ; four bones in the pelvis and hips ; one 
breast-bone, called sternum ; and a bone at the base of the tongue, 
called OS hyoides. They are so put together as to form two great 
cavities, namely, the thorax or chest, and the abdomen or belly. 

The ribs, connecting with the back bone behind, and the breast 
bone in front, form the thorax, 
which contains the lungs and 
heart. The Figure 6 shows the 
natural form of the healthy chest : 
1, is the spine; 2, 2, the collar 
bones ; 3, 3, the seven upper, or 
true ribs ; 4, 4, the five lower or 
false ribs; 5, the breast bone, to 
which the true ribs are united ; 6, 
the sword-shaped cartilage which 
constitutes the lower end of the 
breast bone, called ensiform car- u 
tilage ; 7, 7, the upper part of the 
two lungs ; 8, 8, the right lung 
seen between the ribs; 9, 9, the4i 
left lung ; 10, 10, the heart ; 11, 
11, the diaphragm, or midriff; 12, 
12, the liver ; 13, 13, the stomach; 
14, 14, the second stomach, or duodenum ; 15, the transverse colon ; 
16, the upper part of the colon on right side; 17, upper part of colon 
oh left side. 



Fig. 




22 



ANATOMY. 



liG. 7. 



Each piece of the spinal column is called a vertebra. Upon every 
one of these are seven projections, called 
processes^ — a part of which are for linking 
the bones together, and the rest to furnish 
attachments for the muscles of the back. 

The projections are linked together in 
such a way, that a continuous channel or 
opening runs down through the whole, in 
which is lodged the spinal cord, or medulla 
spinalis. This nervous cord is connected 
with the base of the brain, and is a kind of 
continuation of it. 

Between all the vertebrae are certain car- 
tilaginous cushions, which, when compressed, spring back, like India 
rubber, and thus protect the brain from being injuriously jarred by 
running, leaping, or walking. 

The pelvis has four bones ; the two nameless bones, — innominata, — 
the sacrum, and the coccyx. In the side of each of the nameless bones 




Fig. 8. i^s a deep, smooth cavity, called 

the acetabulum. Into this the 
round head of the thigh bone is 
nicely fitted. When the bone is 
thrown out of this cavity, the 
hip is said to be out of joint. 
The sacrum took its name from 
the fact that the heathens used 
to offer it in sacrifice. With 
them, it was the sacred bone. 
The coccyx is the lower termi- 
nation of the back-bone. These 
bones are represented in Figure 
8 : 1, 1, being the innominata; 2, the sacrum ; 3, the coccyx ; 4, 4, the 
acetabulum ; a, a, the pubic portion of the nameless bones ; d, the 
arch of the pubes ; c, the union of the sacrum and the lower end of 
the spinal column. 




Bones of the Upper Extremities. 

The shoulder blade (scapula), the collar bone (clavicle), the bone of 
the tipper arm (humerus), the tico bones of the fore-arm (ulna and radi- 
us), the bones of the icrist (carpal bones), the bones of the palms of the 
hand (metacarpal bones), the bones of the thumb and finders (phalan- 
ges), — these are the bones of the upper limbs. 

The collar bone is fastened at one end to the breast-bone, at the 
other end to the shoulder blade. It keeps the shoulders from dropping 
forward. Many persons allow it to fail of this end by getting very 
much bent in early life. This happens at school, when children are 
allowed to sit in a stooping posture. In the French, a race remarka- 
ble for a straight, upright figure, this bone is said to be longer than in 
any other people. 



ANATOMY. 



23 



The shoulder blade lies upon the upper part of the back, forming 
the shoulder. It has a shallow cavity (glenoid cavity), into which is 
inserted the head of the upper arm bone. Several strong muscles are 
attached to the elevations of this bone, which keep it in its place, and 
move it about as circumstances require. 

The upper arm bone has its round head fastened in the glenoid cav- 
ity, by the strong capsular ligament, forming a joint capable of a 
great number of movements. At the elbow it is united with the ulna 
of the fore-arm. It is a long cylindrical bone, represented by Figure 
9 : 1, is the shaft of the bone ; 2, the large round head which fits into 
the glenoid cavity ; 3, the surface which unites with the ulna. 

Of the two bones of the fore-arm, the ulna is on the inner side, and 
unites with the humerus, making an excellent hinge-joint. The other 
bone of the fore-arm, the radius^ lies on the outside of the arm, — on 
the same side with the thumb, — and unites, or articulates, as we say, 
with the bones of the wrist. In Figure 10: 1, is the body of the 
ulna ; 2, the shaft of the radius ; 4, the articulating surface, with 
which the lower end of the humerus unites ; 5, the upper extremity 
of the ulna, called the olecranon process, which forms the elbow joint; 
6, the point where the ulna articulate with the wrist. 



Fig. 9. 



Fig. U. 



Fig. 10. 





The eight bones of the xurist or carpus are ranged in two rows, and 
being bound close together, do not admit of very free motion. In 
Figure 11: s, is the scaphoid bone; l, the semilunar bone; c, the 
cuneiform bone ; p, the pisiform bone ; t, t, the trapezium and trajx^- 
zoid bones; m, the os magnum; u, the cuneiform bone. The X'a^X four 
form the second row of carpal bones. 11, 11, are the metacarpal bones 
of the hand ; 2, 2, the first range of the linger bones ; 3, 3, the second 
range of finger bones ; 4, 4, the third range of fmger bones ; 5, 6, the 
bones of the thumb. 



24 



ANATOMY. 



Of the five metacarpal bones, four are attached below to the first 
range of the finger bones, and the other to the first bone of the 
thumb, while the whole are united to the second range of the carpal 
bones above. 



Bones of the Lower Extremities, 

These are the thigh-bone (femur), the knee-pan (patella), the shin- 
bone (tibia), the small bone of the leg (fibula), the bones of the instep 
(tarsal bones), the bones of the middle of the foot (metatarsal bones), 
and the bones of the toes (phalanges). 

The thigh bone is the longest bone in the system. Its head, which 
is large and round, fits admirably into the cavity in the fig. 12. 
innominatum, called acetabulum, and forms what is 
called a ball-and-socket joint. In Figure 12 : 1, is the 
shaft of the thigh bone (femur) ; 2, is a projection called 
the trochanter minor, to which some strong muscles are 
attached ; 3, is the head of the femur which fits into the 
acetabulum ; 5, is the external projection of the femur, 
called the external condyle ; 6, the internal condyle ; 7, 
the surface which articulates with the tibia, and on which 
the patella slides. 

The knee pan or knee cap (patella) is placed on the 
front of the knee, and being attached to the tendon of 
the extensor muscles above, and to the tibia by a strong 
ligament below, it acts as a pully in lifting up the leg. 

The shin bone (tibia) is the largest of the two in the 
lower leg, and is considerably enlarged at each end. 
FiQ. 13. The small bone of the leg (fibula) lies on 

the outside, and is bound to the larger bone 
at both ends. Figure 13 shows the two 
bones of the leg : 1, being the tibia ; 5, the 
fibula ; 8, the space between the two ; 6, the 
junction of the tibia and fibula at the upper 
extremity ; 3, the internal ankle ; 4, the lower 
end of the tibia that unites with one of the 
tarsal bones to form the ankle joint; 7, the upper end of 
the tibia which unites with the femur. 

The instep (tarsus) has seven bones, which, like those of 
the wrist, are so firmly bound together as to allow but a 
limited motion. 

The metatarsal bones, corresponding with the palm of 
the hand, are five in number, and unite at one end with 
the tarsal bones, and at the other, with the first range of 
the toe-bones. 

The tarsal and metatarsal bones are put together in the 
form of an arch, the spring of which, when the weight of 
the body descends upon it in walking, prevents injury to 
the organs above. (Fig. 14.) 

The phalanges have fourteen bones. The great toe has 




ANATOMY. 



25 



two ranges of bones ; the other toes have three. Figure 15 gives a 
view of the upper surface of the bones of the foot : 1, is the surface 
of the astragalus where it unites with the tibia ; 2, the body of the 

Fig. 15. 



Fig. 14 





astragalus ; 3, the heel bone (os calcis) ; 4, the scaphoid bone ; 5, 6, 
7, the cuneiform bones ; 8, the cuboid ; 9, 9, 9, the metatarsal bones ; 
10, the first bone of the great toe ; 11, the second bone ; 12, 13, 14, 
three ranges of bones forming the small toes. 

The Joints. 

That bones may be of any use, they must be jointed together. 
Joints are of the greatest importance* It is necessary they should be 
so constructed that there shall be no harsh grating of the bones upon 
each other, and no injurious jars in walking, etc. To prevent these 
things, a hard, smooth, and yet yielding, cushion-like substance is 
required between them in joints. Such are the cartilag-es. Figure 16 
Fig. 16. gives a specimen of these 

intervening cartilages. D, 
is the body of a bone, at 
the end of which is a sock- 
let; C, the cartilage lining 
the socket, thick at the sides 
and thin in the centre ; B, 
the body of a bone, at the end of which is a round head ; C, the in- 
vesting cartilage, thin at the sides and thick in the centre. 

Cartilage grows thinner, harder, and less elastic in old age. Hence 
old people are not quite as tall as in middle life, and a little stiller in 
their joints. 

The synovial membrane is a thin layer covering the cartilage, ami 
being bent back upon the inner surface of the ligaments, it forms a 
closed sack. From its inner surface a sticky fluid oozes out, which 
helps the joints to play easily. 

4 




26 



ANATOMY. 



There are other smaller sacks connected with the joints, called 
bursa mucosae. They secrete a fluid similar to that from the syno- 
vial membrane. 

The liir'aments. To retain the bones in their places at the joints, 
some strong, flexible straps are required to stretch across from one to 
the other, and to firmly unite them. Such are the ligaments. 

They are the pearl-colored, lustrous, shining parts about the joints, 
in the form of straps and cords. There are a number of them so 
Avoven together as to form a complete coverinsr of the joint, called a 
capsular ligament. In Figure 17 : 8, 9, are ligaments extending from 
the hip bone, 6, to the femur, 5. In Figure 18 : 2, is the socket of 



Fig. 17 



Fig. 18. 



Fig. 19. 




the hip joint ; 5, the head of the femur, lodged in the socket ; 3, the 
ligament within the socket. In Figure 19 : 1, is the tendon of the 
muscle which extends the leg ; 2, the knee cap (patella) ; 3, the ante- 



rior ligament of the patella 
4, 4, the synovial membrane 



6, the long external lateral ligament 
5, the internal lateral ligament ; 7, the 



anterior and superior ligament that unites the tibia with the fibula. 



Uses of the Bones. 



The bones are to the body what the frame is to the house. They 
hold up and retain the other parts in their proper places. They fur- 
nish points of attachment for the muscles, to hold the body together, 
and to give it motion. They also furnish strong, bony cavities for the 
lodgement and protection of such delicate organs as the eye, the brain, 
and the heart. 

A single bone, examined by itself, might not seem to have much 
beauty or design about it ; it might even look clumsy and misshapen. 
But when all the bones are inspected with reference to each other, we 
immediately discover a general plan upon which they are made, and 
are compelled to admire their beautiful harmony, and the symmetrical 
grace with which they act. They show us that God can command 
our wonder, even in the bony frame of our bodies. 



ANATOMY. 27 



The Muscles. 

That part of the animal's body which we call lean meat is com- 
posed of muscles. We have already explained that muscles are com- 
posed of threads, etc., put together in great numbers, forming bundles. 
So numerous are these threads and bundles in some cases, that the mus,r 
cles which are composed of them, have a strength truly wonderful 

Toward the end of the muscle, the fibres cease, and the structure 
is so modified as to become a white cord of great density and strength. 
This cordy substance is fastened to the bone so strongly, that it is 
impossible, except in some rare case, to detach it. Generally the 
bone will sooner break than this attachment will give way. Some- 
times this cord spreads out like a membrane. It is then C3.[led fascia 
or aponeurosis. 

The fibres of a muscle have the peculiar property of contracting- 
under a nervous stimulus sent to them by the will. These contrac- 
tions cause them to act as pullies, and to move the bones, and conse- 
quently the limbs and body, in such direction as the will commands. 
This is the special use of the muscles. All our movements are caused 
by them. They pull us about, not blindly and at random, but under 
the direction of an intelligent will. 

The manner in which a muscle acts, with the cord attached, may 
be seen by examining the leg or " drum-stick " of a fowl. If the cord 
on one side be pulled, the claws are shut ; if that upon the other 
side be drawn, they will open. If both be pulled, they are held fast 
in one position, neither opening nor shutting. 

An examination of a piece of boiled lean meat, will show the 
threads of which it is composed. With proper instruments, these may 
be unravelled, as it were, until fibres will be found not larger than a 
spider's web. These, covered with sheaths of great delicacy, extend 
beyond the fleshy fibre, and with the cell substance connecting the 
fibres, are condensed into tendon. 

Millions of these sheathed fibres are gathered into a bundle, and 
covered with a sheath, and thus form what is called s, fasciculus. A 
muscle is a number of these fasciculi made into a bundle, and covered 
with a sheath called a fascia. (Fig. 1.) 

The arm is a number of muscles bundled together, and covered, 
likewise, by a fascia. 

The fibres in a fasciculus being parallel, act together. But the fas- 
ciculous bundles, which make up a muscle, act in various ways. 

Shape of the Muscles. — Some muscles are fusiform or spindle- 
FiG. 20. shaped, so that the attachment occupies but a 

^;^^^^^^^^^ small space. (Fig. 20.) 

^^^^^^^^ Other muscles are radiate or fan-shaped. (Fig.:21.) 
Such is the temporal muscle, the thin edge of Fig. 21. 

which is attached to the side of tlie head, without 
producing an elevation or deformity. 

In some cases the fasciculi are arranged upon 
one or both sides of a tendon. In this way a 




ANATOMY. 



great number may concentrate their action upon a single point. Such 
muscles are called penniform^ — being shaped like Fia. 22. 

the feather end of a pen. (Fig. 22.) i^^ ^ ^^^" 

In other instances, the fasciculi form circular ~"^^^^^^^^ 
muscles, — orbiculares, or sphincters^ as they are called. These sur- 
round certain openings into the body, which they are designed to 
Fio. 23. close, either in whole or in part. They surround the eye- 
lids, the anus, the mouth of the womb, etc. (Fig. 23.) 

In still other instances the fasciculi are ranged side by side 
in rings, forming muscular tubes. By the successive contrac- 
tion of these rings, any substance is driven through the tube, — as 
food or drink through the ria,24. 

gullet of a cow. Figure 
24 is a section of the gul- 
let: a, ^, show the circu- 
lar fibres ; c, the longitudinal. 





Fig. 25. 



Sometimes the fasciculi curve around in parallel layers, or interlace 

with each other, forming a bag or 
pouch. By the contraction of these 
fasciculi, the contents of the bag 
will be turned from side to side, 
as in the case of the stomach, 
or driven out as in that of the 
heart. Figure 25 shows the mus- 
cles of the stomach : l, represents 
the fibres running in one direc- 
tion ; c, in another ; e, lower end 
of gullet ; o, pylorus ; d, begin- 
ning of duodenum, or second 
stomach. 




Nnmber of Muscles. — The muscles of the body are as numerous 
as the ropes of a ship, — there being five hundred or more. Some 
anatomists reckon more, some less. 

They are divided into those of the head and neck^ those of the 
trunks those of the upper extremities^ and those of the lower extremi- 
ties. 

They are too numerous to be named and individually described in 
this brief account of them. A part of them are voluntary, that is, 
under the control of the will ; while another part are involuntary, 
moving without reference to the will. The heart is of the latter kind, 
it being necessary for it to keep moving when the will and mind are 
asleep. 

On the back there are six layers of muscles, one above another. 
Such a number are necessary to perform the numerous movements 
of the back, neck, arms, etc. Every expression of the human face, as 
joy, sorrow, love, hate, hope, fear, etc., is produced by the gentle pul- 
ling of muscles, made expressly to indicate these emotions. 

The diaphragm is a large flat muscle, reaching across the great 
cavity of the body, and dividing the chest fioni the belly. It is pen- 



ANATOMY. 29 



etrated by the food-pipe going to the stomach, and by the great blood 
vessels leading to and from the heart. It is shaped like the cover 
of a dinner-dish, the convex surface being turned up. "When the 
breath is drawn in, it sinks down towards a level, thus enlarging 
the chest at the expense of the belly. When the breath is thrown 
out, the reverse takes place. 

Mode of Action. — The contractibility of a muscle, of which I have 
spoken, is simply its power of shortening itself. The hand is raised 
by the shortening of a muscle in front, attached to the bone above 
Fig. 26. the elbow, and to a bone be- 

Jv low the elbow. The con- 
traction of an antagonistic 
muscle behind, also attached 
above and below the elbow, 
brings the hand back to its 
place. Figure 26 shows how 
all joints are moved : 1, is 
the bone of the arm above 
"2 '^" ~^ "^ ' the elbow ; 2, one of the 

bones below the elbow ; 3, the muscle which bends the elbow ; 4, 5, 
attachments of muscle to bones ; 6, the muscle that extends the 
elbow ; 7, attachment to elbow ; 8, weight in hand. The muscle, 3, 
contracts at the central part, and brings the hand up to 9, 10. 

The complication, variety, and swiftness of motion, executed by 
muscles, are past conception. Every movement which a human be- 
ing makes, from the heavier motions of the farmer in cultivating his 
fields, up to the magic touches of the painters brush, and the method- 
ical frenzy with which the great master's fingers sweep the piano, are 
all made by muscles obeying an intelligent will. 




The Teeth. 

The teeth are not like other bones, either in composition, method of 
nutrition, or growth. When broken they do not unite, not being fur- 
nished with the necessary power of reproduction of lost parts. 

Both the upper and lower teeth are set into bony sockets, called 
alveolar processes. These, with the fibrous gums, give the teeth a 
very firm setting. 

Orio'iu. — The teeth have their origin in little membranous pouches 
within the bone of the jaw ; and in their interior, have a fleshy bud. 
From the surface of this the bone or ivory exudes. The tooth and 
the bony socket are developed and rise up together, — the former, 
when sufficiently long, pushing itself through the gum. 

^'limber. — The first set of teeth are only temporary, and are called 
milk teeth. There are but twenty of them. Between the age of six 
and fourteen, these become loose, and drop out, and the permanent 
teeth appear in their places. Of these there are thirty-two, sixteen 
in each jaw. 



30 



ANATOMY. 



Names. — The four front teeth in each jaw, a^ b, Figure 27, are the 
ciUting teeth (incisors) ; the next one, c, is an eye tooth (cuspid) ; the 

Fio. 27. 




next two, c?, e, are small g'rinders (bicuspids) ; the last three,/, g, h, are 
grinders (molars). One appears late on each side, from the age of 
twenty to twenty-four, and is called wisdom tooth. 

Composition. — A tooth is composed of ivory and enamel. The 
internal part is ivory, which is harder than bone. The coating upon 
the surface is enamel^ which is still harder than ivory. That part 
which rises above the jaw bone is called the crown; it is this only 
which is covered with enamel. The part within the jaw is called the 
root or fang; this is composed of bony matter, through which small 
vessels pass in to nourish the tooth. Small white nerves also pass 
into the tooth, — of the presence of which we have terrible evidence 
in tooth-ache. 

Use of the Teeth. 

The incisors cut the food asunder; the molars break down its 
solid parts, and grind it to a fineness which fits it for the stomach. 

In masticating the food, the lower jaw has two movements, the up 
and down motion, like a pair of shears, and the lateral or grinding 
motion. These two movements are performed by different sets of 
muscles. Flesh-eating animals have only the up and down motion ; 
vegetable eating animals have only the lateral or grinding motion ; 
while man has both the up and down and the lateral. This seems 
a pretty clear intimation that he is to eat both flesh and vegeta- 
bles. 

The teeth aid us in articulating words, and they give a roundness 
and symmetry to the lower part of the face. When well formed, and 
kept in good condition, they add much to the beauty of the face, and 
their decay is an irreparable loss. Their proper care and treatment 
are spoken of in another place. 



ANATOMY. 



31 



The Digestive Organs. 

The alimentary organs are the mouth, the teeth, the salivary glands, 
the pharynx, the stomach-pipe (oesophagus), stomach, bowels (intes- 
tines), chyle vessels (lacteals), thoracic duct, liver, and sweet bread 
'pancreas). 

The preparatory process of digestion, the mastication of food, takes 
place in the mouth, where the food is mixed with saliva, a secretion of 
the salivary glands. Of these glands there are six, three on each side. 

The Parotid Gland lies in front of the external ear. It has a duct 
opening into the mouth opposite the second molar tooth of the upper 
jaw. This is the gland that swells in the disease called mumps. 
Hence the disease is also called parotitis. 

The Submaxillary Gland is inclosed within the lower jaw, in front of 
j,j^ 28 ^^^ angle. Its duct opens 

into the mouth by the side 
of the bridle of the tongue 
(fraenum linguae). 

On each side of this string 
or bridle, and under the mu- 
cous membrane of the floor 
of the mouth, lies the sublin- 
gual g-land, which pours 
its saliva into the mouth 
through seven or eight small 
ducts. A disease called the 
frog', consists in the swel- 
ling of this gland. Figure 
28 : 1, the- parotid gland ; 
2, its duct; 3, the submaxil- 




FiG. 29. 



lary ; 4, its duct ; 5, the sublingual. 

The Pharynx is a continuation of the 
month, and is the cavity just below the 
soft palate. The two passages going to 
the nose (posterior nares), the one going 
to the stomach (oesophagus), and the one 
going to the lungs (larynx and trachea), 
all meet in this cavity. In Figure 29 : 1, 
is the trachea ; 2, the larynx ; 3, the oeso- 
phagus ; 4, 4, 4, muscles of the pharynx ; 
5, muscles of the cheek ; 6, the muscle 
which surrounds the mouth ; 7, the mus- 
cle forming the floor of the mouth. 

The Stomach Pipe is a long tube, like 
the fireman's hose, descending behind the 
wind-pipe, the lungs, and the heart, through 
the diaphragm into the stomach. It is composed of two membranes 
laid together, like two pieces of cloth. The inner one is mucous, the 




32 ANATOMY. 



outer muscular. The two sets of fibres composing the muscular coat 
are arranged circularly and longitudinally. (Fig. 25.) 

Tlie Stomach lies in the upper part of the belly, to the left, and di- 
rectly under the diaphragm. It has an upper opening, where the 
stomach-pipe enters it, called the cardiac orifice. This is the larger 
end of the stomach, and lies on the left side ; the smaller end con- 
nects with the upper bowel, at which point it has an opening called 
the pyloric orifice. In addition to mucous and muscular coats, simi- 
lar to those which compose the oesophagus, the stomach has still 
another over both, a serous coat, very strong and tough, to give this 
working organ additional endurance. Within, it has many glands to 
secrete the gastric juice. 

The Intestines or alimentary tube^ or bovjels, are divided into the 
small and the large intestines. 

The small intestine has a length of about twenty-five feet, and is 
divided into three parts, — the duodenum, the jejunum, and the ileum. 

Of these three divisions, the duodenum is the largest, and is about 
a foot in length. It begins at the pyloric orifice of the stomach, and 
passes backward to the under surface of the liver, whence it drops 
down perpendicularly in front of the right kidney, and passes across 
the belly behind the colon, and ends in the jejunum. 

The Jejunum continues the above, and terminates in the ileum. 

The Ileum is a continuation of the jejunum, and opens, at an obtuse 
angle, near the haunch bone, into the colon. A valve is located here, to 
prevent the backward passage of substances from the colon into the 
ileum. 

At this point the large intestines begin, and here is situated the 
caecum, a blind pouch, or cul-de-sac, attached to which is the appendix 
vermiformis, a worm-shaped tube, of the size of a goose quill, and 
from one to six inches long. 

The Colon or larg-e intestine, is divided into the ascending colon, the 
transverse colon, and the descending colon. 

The Ascending Colon rises from the right haunch bone to the under 
surface of the liver, whence it bends inward, and crosses the upper 
part of the belly, below the liver and stomach, to the left side. This 
portion which crosses over is the transverse colon. From this point, on 
the left side, it turns down to the left haunch, and has the name of the 
descending colon. Here it makes a curve like the letter S, which is 
called the sigmoid flexure. 

The Rectum is the lower portion of the large intestine, terminating 
at the anus. 

The Lacteals are small vessels which begin in the villi, upon the 
mucous membrane of the small bowels. From here they pass be- 
tween membranes of the mesentery to small glands, from which larger 
vessels run to another collection of glands ; and after passing, for a 
space, from one collection of glands to another, at each stage of their 
progress increased in size and diminished in number, the lacteals pour 



ANATOMY. 



33 



rough 



Fig. 30. 




Fig. 31. 



their contents into the thoracic duct. This having passed up th 
the diaphragm, out of the belly, makes a sudden turn downward and 
forw^ard, and empties its burden into a large vein which ends in the 
right heart. Figure 30 : 1, is the bowel ; 2, 3, 4, the mesenteric 

glands through which the lacteals pass ; 
5, the thoracic duct ; 7, the spinal column ; 
8, the diaphragm. 

By the help of a magnifying glass, an 
infinite number of these small vessels may 
be seen starting from the rough, shaggy in- 
ternal coat of the bowel. 

The mesentery is a thick sheet of mem- 
brane, formed of several folds of the peri- 
toneum, and spread out from the vertebrae 
like a fan. The bowels are attached to 
its edge, and are held by it in their place, 
and at the same time, have free motion. 
Between its layers are a great number of 
glands, which sometimes become diseased 
and swollen in childhood, and prevent the chyle from passing along to 
the thoracic duct. Thus affected, children are not nourished, and waste 
away with a disease sometimes called mesenteric consumption. 

The Liver is a large gland, lying under the short ribs on the right 
side, below the diaphragm. It 
is convex on the upper surface 
and concave on the under, and 
is composed of several lobes. 
Its office is to secrete bile. It 
weighs about four pounds, be- 
ing the largest organ in the 
body. Figure 31 represents the 
liver ; 1, being the right lobe ; 
2, left lobe ; 3, 4, smaller lobes ; 
10, gall bladder ; 17, the notch 
into which the spinal column is 
fitted. 

The fJiiU-Bladtler lies on the under side of the liver, and receives, 
it is supposed, the surplus bile, which is reserved for special occa- 
sions. It opens into the gall duct, which carries the bile along, and 
pours it into the duodenum. 

The Paucreas, Figure 32, is a long, flat gland, something like the sali- 
J.JQ 32, vary glands. It lies trans- 

versely across the back wall 
of the abdomen, behind the 
stomach. It secretes a iluid 
called the pancreatic juice, 
a peculiar kind of saliva, 
the odice of which is to 
emulsion fat, so that the 
5 





84 ANATOMY. 



lacteals can absorb it. This fluid is carried by a duct, and poured 
into the duodenum just where the bile duct enters. 

The Spleen or milt^ has an oblong, flattened form. It lies on the 
left side, just under the diaphragm, and close to the stomach and pan- 
creas. It is supposed to be a reservoir for holding the surplus blood 
of the liver. It was thought by the ancients to be the seat of melan- 
choly. The blood in passing through it loses a portion of its red 
globules. 

The Omeiituiii or caul is a doubling and extension of the peri- 
toneum. It is a kind of fatty body, which lies upon the surface of 
the bowels, and is attached to the stomach. Its use seems to be to 
lubricate the bowels, and especially to protect and keep them warm. 
Hence it is often called the apron. 

The Urinary System. 

The organs of this system are devoted to separating the urine from 
the blood, and carrying it out of the body. These organs are the 
kidneys^ the ureters^ the bladder^ and the urethra. 

The Kidneys lie one on each side of the back bone, in the lumbar 
region, behind the peritoneum. They are four or five inches long, 
and. two and a half broad. They are in shape like the kidney bean, 
and weigh about half a pound each. In the centre there is a bag 
called the pelvis, which tapers like a funnel, and forms the ureter 
which conveys the urine to the bladder. The texture of the kidney 
is dense, presenting in its interior, two structures, an external or 
cortical, and an internal or medullary. The cortical portion has the 
blood vessels, the medullary is composed of tubes which carry away 
the urine. 

The Ureters are membranous tubes of the size of a goose quill, 
and eighteen inches long, which run down the back wall of the abdo- 
men, behind the peritoneum, to the bladder, into each side of which 
they empty their contents. 

Tlie Bladder is located in the pelvis or basin, in front of the rec- 
tum. It is composed of three coats ; the external is serous, the middle 
muscular, and the internal mucous. The external coat is strong and 
fibrous ; the internal is drawn into wrinkles, which makes it thick and 
shaggy ; it secretes a mucus which prevents it from being injured by 
the corrosiveness of the urine. The urine is retained in the bladder by 
means of a circular muscle, called a sphincter^ which draws the mouth 
of the organ together. When the quantity of urine is so increased 
as to give some uneasiness or pain, this muscle, by a sort of instinct, 
relaxes and lets it out. 

The bladder is attached to the rectum, to the hip bones, to the peri- 
toneum, and to the navel, by several ligaments. In the female the 
bladder has the womb between it and the rectum. 

This organ is wisely provided as a receptacle for the urine ; which, 
without it, would produce great inconvenience by being constantly 
dribbling away. 



ANATOMY. 35 



The Uretlira is a membranous canal which leads from the neck 
of the bladder. It is composed of two layers, a mucous, and an elas- 
tic fibrous. Through this channel, which is curved in its course, the 
urine passes out of the body. 



The Respiratory Organs. 

These organs consist of the wind-pipe (trachea) ; divisions and sub- 
divisions of the wind pipe (bronchia) ; air cells ; and the lungs or 
lights. 

Tlie Windpipe (trachea) extends from the larynx^ — the seat of the 
voice, — to the third dorsal vertebra, where it divides into two tubes, 
called bronchia. It runs down the front part of the throat, with the 
oesophagas behind and between it and the spinal column. It is com- 
posed mainly of rings of cartilage, one above another. 

Tlie Bronchial Tubes are, at the division of the windpipe, two in 
number, but they divide and subdivide until they become very nu- 
merous. 

Tlie Air Cells or Vesicles are small, bladder-like expansions at the 
ends of the tubes. They are elastic, and swell out when the air 
passes in. 

The Luno's fill the greater part of the chest, the heart being the only 
other organ which occupies much space in the cavity. The size of 
these organs is large or small, according to the capacity of the chest. 
Each lung, — for there are two, — is a kind of cone, with its base 
resting upon the diaphragm, and its apex behind the collar bone. 
They are concave on the bottom, to fit the diaphragm, which is con- 
vex on its upper side. 

There are two lungs, a right and a left. These are separated from 
each other by a partition formed from the pleura, and called the med- 
iastinum. Two portions of the pleura, coming off from the spine, 
form this partition ; and the heart, covered by the pericardium, lies 
in the centre, between them. The right lung is divided into three 
lobes ; the left into two. 

Each lobe of the lungs is divided into a great many lobules^ which 
are connected by cellular tissue. These lobules are again divided 
into very fine air-cells. Beside these, the substance of the lungs is 
composed likewise of blood vessels, and lymphatics, and is well sup- 
plied with nerves. 

In the fetal state, before the lungs have been filled with air, they 
are solid and heavy, something like other flesh, but after all their cells 
have been filled with air, and breathing has been established, they are 
exceedingly light and spongy, and float upon water. 

In cases where the murder of children is suspected, and where it is 
desirable to know whether they were still-born^ or born alive and killed 
afterwards, the specific gravity of the lungs, compared with water, 
will often settle the question. 



36 ANATOMY. 



The Organs of Circulation. 

The food having been digested, changed to chyle, absorbed by the 
lacteals, carried to the veins, poured into the right heart, sent up to 
the lungs, and prepared for nourishing the body, will still be useless, 
if not distributed to every part of the system. The organs for effect- 
ing this distribution, are the hearty the arteries^ the veins, and the cap- 
illaries. 

The Heart is placed obliquely in the chest, with one lung on each 
side, and is enclosed between the two folds of the mediastinum. Its 
form is something like a cone. Its base is turned upward and back- 
ward in the direction of the right shoulder ; the apex forward and to 
the left, occupying the space between the fifth and sixth ribs, about 
three inches from the breast-bone. It is surrounded by a membranous 
case or sac, called the pericardium. 

The heart is a muscular body, and has its fibres so interwoven that 
it is endowed with great strength. It is a double organ having two 
sides, a right and a left, which are divided from each other by a mus- 
cular partition, called a septum. The right heart sends the blood to 
the lungs ; the left heart distributes it to the general system. Each 
side is divided into two compartments, an auricle and a ventricle. 

The Aui'icles have thinner walls than the ventricles, being only reser- 
voirs to hold the blood until the ventricles force it along to other parts. 

Tlie Veiiti'icles have within them fleshy columns, called columnce 
carnecE. The walls of the left ventricle are thicker than those of the 
right, being required to contract with more force. Each of the four 
cavities will contain from one and a half to two ounces of blood. 

The Tri-cuspid valves are situated between the auricle and ventricle 
on the right side, and consist of three folds of a thin, triangular 
membrane. The mitral valves occupy the same position on the left 
side. Small white cords, called chordce tendince, pass from the floating 
edge of these to the columnse carneae, to prevent the backward pressure 
of the blood from carrying the valves into the auricles. 

The pulmonary artery is the outlet of the right ventricle ; the larger 
artery, called aorta, of the left ventricle. At the pio. 33. 

opening of these arteries, are membranous folds, 
called semilunar valves. Figure 33 gives a fine 
view of the heart : 1, is the right auricle ; 2, the 
left auricle ; 3, the right ventricle ; 4, the left ven- 
tricle ; 5, 6, 7, 8, 9, 10, the vessels which bring the 
blood to and carry it away from the heart. 

The Aiteries are the round tubes which carry 
the red blood from the left side of the heart to 
every part of the body. 

The sides of arteries are stiff* and hard, and do 
not fall together when empty. They may often 
be seen open in a piece of boiled beef. 

The arteries have three coats, — an external, which is cellular, firm 




ANATOMY. 37 



and strong ; a middle, which is fibrous and elastic ; and an internal, 
which is serous, and smooth, being a continuation of the lining of 
the heart. They are surrounded by a cell vestment called a sheath^ 
which separates them from surrounding organs. 

The Pulmonary Artery starts from the right ventricle in front of the 
opening of the aorta, and ascends to the under surface of the aortic 
arch, where it parts into two branches, sending one to the right, the 
other to the left lung. Having divided and subdivided to a great extent, 
they end in the capillary vessels, uniting, joining their mouths, and 
becoming continuous with the pulmonary veins just where they pass 
around the air-cells. 

The Aorta is the largest artery in the body. It takes a slight turn 
in the chest, called the arch of the aorta^ from which are given off the 
arteries which carry the blood to the head, etc. ; thence it descends 
into the belly along the side of the back bone, and at the bottom of 
the abdomen it divides into two arteries, called the iliacs — one going 
to each of the lower limbs. The branches the aorta gives off supply 
red blood to every part of the body. 

The Veins carry the dark or purple blood. Being made red and 
vital by meeting atmospheric air in the lungs, and then conveyed to 
every part of the body in the arteries, the blood loses its redness in 
the capillaries, and comes back to the heart in the veins, dark and 
purple, and unfit to support life. The veins are more numerous and 
nearer the surface than the arteries. They have, likewise, thinner 
walls, and when empty, they collapse or fall together. They begin 
in the small capillaries, and running together, they grow larger and 
larger, and finally form the great trunks which pour the dark blood 
into the right auricle. The veins are composed of three coats, similar 
to those of the arteries, with the exception of being thinner and more 
delicate. These vessels have valves all along their inner surface, to 
aid in circulating the blood. 

The large vein which receives all the dark blood from above, and 
pours it into the right auricle, is called the vena cava descendens ; the 
one which takes it from below, and disposes of it in the same manner, 
is the vena cava ascendens. 

The pulmonary veins bring the red blood from the lungs to the left 
auricle, and thus are exceptional in their use, — being the only veins 
which carry red blood. 

The Capillaries are the extremely fine net- work of vessels between 
the ends of the arteries on the one side, and of the veins on the other. 
They inosculate, or join their mouths to the very small arteries at 
one end, and to the equally small veins at the other. They are the 
industrious little builders of the human frame. Receiving the blood, 
red, and full of life, from the terminal extremities of the arteries, \\\c\ 
take the living particles out of it, and apply them to the renewing 
and vitalizing of the body, and then pass it along into the hair-like 
beginnings of the veins, dark and bereft of vitality, to be carried up for 



38 



AJs^ATOMY. 



another freight of chyle, and to be again vitalized by being touched 
in the lungs by the breath of heaven. 

In Figure 34 we have a good ideal illustration of the whole circu- 
lation. From the right ventricle 
of the heart, 2, the dark blood is 



Fia. 34. 




thrown into the pulmonary arte- 
ry, 3, and its branches, 4, 4, carry 
it to both lungs. In the capillary 
vessels, 6, 6, the blood comes in 
contact with the air, and becomes 
red and vitalized. Thence it is 
returned to the left auricle of the 
heart, 9, by the veins, 7, 8. Thence 
it passes into the left ventricle, 
10. A forcible contraction of this 
sends it forward into the aorta, 11. 
Its branches, 12, 13, 13, distribute 
it to all parts of the body. The 
arteries terminate in the capilla- 
ries, 14, 14. Here the blood loses 
its redness, and goes back to the 
right auricle, 1, by the vena cava 
descendens, 15, and the vena 
cava ascendens, 16. The tricus- 
pid valves, 17, prevent the reflow 
of the blood from the right ven- 
tricle to the right auricle. The 
semilunar valves, 18, prevent the 
blood from passing back from the 
pulmonary artery to the right ventricle. The mitral valves, 19, pre- 
vent its being forced back from the left ventricle to the left auricle. 
The semilunar valves, 20, prevent the backward flow from the aorta 
to the left ventricle. 

By a careful examination of this diagram, with these explanations, 
the reader may understand the circulation very well. 

The passage of the blood from the right heart, through the lungs, 
and back to the left heart, is called the lesser, or pulmonic circulation ; 
its passage from the left heart through all parts of the body, and back 
to the right heart, is the greater or systemic circulation. 

The Absorbent Vessels. 

The vessels which absorb the chyle from the small intestines, and 
convey it onward towards the blood, are the lacteals. They have 
been described. The veins are also supposed to have the power of 
absorption, particularly the small commencement of the veins. These 
have likewise been described. 

The Lymphatic vessels resemble the lacteals. They abound in the 
skin, the mucous membranes, and the lungs. They are very small at 
their origin, and, like the veins, they increase in size, as they diminish 



ANATOMY. 



39 



in numbers. Like the veins, too, they travel towards the heart, and 

their contents are poured into it. Their walls are composed of two 

coats ; the external is cellular, and distensible ; the internal is folded 

into valves, like that of the veins. 

These vessels, on their way to the heart, pass through soft bodies, 

called lymphatic glands^ which bear to them the relation that the 
-pjQ 35 mesenteric glands do to the lac- 

teals. These glands are a collection 
of small vessels. The lymphatic 
glands are most numerous in the 

neck, chest, abdomen, arm-pits, and groins. They are also found, to 

some extent, in other parts of 



the body. Figure 35 shows a 
single lymphatic vessel, much 
magnified ; Figure 36 exhibits 
the valves along one of the 
lymphatic trunks ; Figure 37 
shows a lymphatic gland, with 
the vessels passing through it. 



Fig. 36. 



Fig. 37. 




Figure 38 represents the 
lymphatic vessels and glands. 
1, 2, 3, 4, 5, 6, show these ves- 
sels of the lower limbs ; 7, the 
inguinal glands; 8, the com- 
mencement of the thoracic 
duct, into which the contents 
of the lymphatics are poured ; 
9, the lymphatics of the kid- 
neys ; 10, those of the stom- 
ach ; 11, those of the liver ; 
12, 12, those of the lungs; 13, 
14, 15, those of the arm ; 10, 1 




18, those of the face and neck ; 



40 ANATOMY. 



20, the large veins ; 21, the thoracic duct ; 26, the lymphatics of the 
heart. 

A cold will often cause lymphatic glands to swell. These swell- 
ings are called kernels. They often swell, also, without the irritation 
from cold, and become very much and permanently enlarged, particu- 
larly in scrofula. In scrofulous subjects they sometimes suppurate 
and break, forming bad sores upon the neck. 

The Organs of Secretion. 

The exhalants, the follicles, and the glands are the organs of secre- 
tion. 

Tlie Exhalants are the sweat-glands. These have external termina- 
tions upon the skin, thus communicating with the air, and internal 
terminations upon the surfaces of organs not having an outward ex- 
posure. 

The Follicles are small sacs, located in the true skin and mucous 
membranes. The pores of the skin are the mouths or outlets of these 
little bags. Veins and organic nerves are sent to these vessels. 

Glands are soft organs, having a variety of structure, and perform- 
ing many kinds of secretion. A gland is p^^ ^ 
made up of several lobules, united in one 
mass, and each of these lobules has a small 
duct communicating with a main duct 
which forms the outlet. Figure 89 shows a 
gland ; 2, the small ducts spread through its 
body, and running together ; 1, the large 
duct, through which the secreted substance 
is carried away. 

The mesenteric and lymphatic glands 
merely modify the fluids which pass through them ; others secrete 
from the blood either fluids to be used in the body, or such as are to 
be cast away. 

The Vocal Organs. 

No sounds touch the heart like those of the human voice, for no 
mechanic, however scientific and skilful, has ever been able to make 
an instrument which could produce sounds as beautiful, tones as 
varied, a timbre as melodious, and inflexions as manifold and agree- 
able. It has been compared to wind, reed, and stringed instruments. 
In touching expression, it is most resembled by the concert-horn, the 
bassoon, and the hautboy. 

Vocal sounds, past all question, are produced in the larynx, but 
these sounds are grouped, or formed into articulate speech, by the 
pharynx, the nasal cavities, the tongue, the teeth, etc. 

The Larynx is a kind of cavity or tube at the top of the windj)ipe, 
formed by the union of five cartilages, namely, the thyroid, the cricoid, 
the two arytenoid, and the epiglottis. Ligaments bind these together, 
and muscles move them. 




ANATOMY. 



41 



Fig. 40. 



The Thyroid Cartila«'e is composed of two parts, and has a con- 
nection with the bone of the tongue above, and with the cricoid car- 
tilage below. 

The Cricoid Cartilage is shaped like a ring, and hence its Greek 
name. It is narrowest in front, and broadest be- 
hind. It connects with the thyroid cartilage above, 
and with the first ring of the trachea below. Fig- 
ure 40 gives a side view of the cartilages of the 
larynx : 1, bone at the base of the tongue (os hyo- 
ides) ; 2, the ligament connecting hyoid bone and 
the thyroid cartilage ; 3, the front of the thyroid 
cartilage ; 4, the thyroid cartilage ; 6, the cricoid 
cartilage ; 7, the windpipe. 

Figure 41 is a back view of the cartilages and 
ligaments of the larynx : 1, is ^^^ ^^ 

the back surface of the epiglot- 
tis ; 3, 3, the os hyoides ; 4, 4, siiBBmw/Mnif^^ 





the lateral ligaments connect- 
ing the OS hyoides and the thyroid cartilage ; 5, 
5, the back face of the thyroid cartilage ; 6, 6, 
the arytenoid cartilages ; 7, the cricoid cartilage ; 
8, the first ring of the windpipe. 

The Arytenoid Cartila«'es are upon the back 
part of the cricoid, and are connected with the 
thyroid cartilage by the vocal cords. 

The Epiglottis is a fibro-cartilaginous lid, shaped 
like a leaf of parsley, which covers the upper open- 
ing of the larynx. It is connected by a cartilage 
to the bone of the tongue (os hyoides) and to the thyroid cartilage. 
Breathing opens and shuts it; and in swallowing, it closes down upon 
the top of the larynx, to prevent food and drink from passing down 
the windpipe. 

The Vocal Cords are two ligaments, formed of elastic and parallel 

fibres, enclosed in a fold of mucous mem- 
brane. They are about two lines in width, 
and inserted behind into the anterior pro- 
jection of the arytenoid cartilages, and 
passing forward, are fixed to the anterior 
angle of the thyroid. There are four liga- 
ments crossing the larynx, two superior, 
and two inferior, — the latter being called 
The interval between them 
is the glottis. The ligaments themselves 
are sometimes called the lips of the g-lotfis. 
The depression between the superior and 
inferior ligaments is the ventricle of the 
larynx. 

Figure 42 represents a view of the larynx from above : a, b, r, the 
thyroid cartilage, enclosing the ring of the cricoid ; //, //, e, c, the 



Fia. 42. 




^1^^ vocal cords. 



42 



ANATOMY 



arytenoid cartilages connected by the transverse arytenoid muscle ; 
i, I, the vocal cords ; o, o, the crico-arytenoid ligaments. 

The muscles which are attached to the cartilages, have the power 
of pulling them about so as to change in various ways the shape of 
the laryngeal cavity ; to enlarge or diminish the size of the glottis ; 
and to relax or tighten the vocal cords. By these means, and some 
others, the sounds of the voice receive their various modifications. 
Tightening the cords, for example raises the pitch. 

The Skin. 



Having no 



Fig. 43. 



The skin is a membrane composed of two layers, covering the 
entire person. The outer layer is the scarf-skin or cuticle ; the inner 
is the true skin or cutis vera. These layers differ in their structure 
and uses. 

The Scarf-Skin, called also cuticle^ and epidermis^ is a thin mem- 
brane, partially transparent, like a thin shaving of horn, 
blood vessels or nerves, and conse- 
quently no feeling, it appears to be 
a simple covering to protect the 
true skin from injury by external 
agents. It is thickest on those 
parts most exposed to friction. 

The scarf-skin is the production 
of the true skin, — an exudation 
from it in the shape of a fluid 
which is spread out as a thin layer, 
and dries up into flattened scales, j 
The cuticle is composed chiefly of 
these scales, and is constantly be- ^ ^^ 
ing rubbed off as scurf, while new 
layers are forming underneath. 

The lower, softer, and more newly-formed layers of the scarf-skin, 
are the seat of color. In this part, the cells contain a pigment, incor- 
porated with the elementary granules, which gives to the various 
races their several shades of color. The depth of hue is dependent 
entirely on the amount of this coloring matter. 

Some physiologists describe the skin as composed of three layers, 
— reckoning this colored part of the cuticle as one, and naming it 
rete mucosum^ or the mucous coat. 

The True Skin, which is called cutis vera, and corium, is a kind of 
web, woven of small fibres collected into strands. In the upper por- 
tion, the web is fine and firm, but grows coarser below. Connected 
with its under surface is a fibrous web in which the fat is deposited. 
Upon its upper surface is the sensitive or papillary layer, composed 
of blood vessels and nerves, doubled into loops, which give little 
prominences called papillae. Figure 43 gives an ideal view of these 
elevations, composed, as they are, of a nerve, an artery, and a vein, 
lying side by side : 1, 1, represent the true skin ; 2, 2, the papillary 




ANATOMY. 



43 



layer ; 3, 3, the arteries ; 4, 4, the veins ; and 5, 5, the nerves of the 
papillae. 

The arteries, veins, and nerves are spread over the true skin in 
o-reat numbers, — so profusely, that it is impossible to push the point 
of the finest needle into it, without piercing a blood vessel and a 
nerve. 

Figure 44 gives a view of the skin : a, a, the cuticle ; Z?, 6, the col- 
ored layer of the cuticle j c, c, dy d, the true skin ; e, e, e, fat cells, 
ftfif') sweat tubes. 




Fia. 45. 





The lymphatics are very numerous in the skin, beside which there 
are oil glands and tubes ^ and sweat glands and tubes. 

The Oil Glands are imbedded in the skin, and communicate with 
the surface by small tubes. They are most abundant on the face, 
nose and ears. Figure 45 shows an oil gland, — a, being the gland, 
b^ the tube, and 6', its mouth. 

The Sweat Apparatus consists of small tubes which pass down 



44 



ANATOMY. 



through the true skin, and terminate in the meshes at the bottom, 
where it coils upon itself into a kind of bundle, called the perspira- 
lory gland. Figure 46 gives one of these tubes, with the gland, mag- 
nified forty diameters : 1, being the coiled tube or gland ; 2, 2, the 
two excretory ducts from the gland. These uniting, form one spiral 
tube, which opens at 4, which is the surface of the cuticle ; 3, are the 
fat cells. 

The hair and the nails are appendages of the skin. 



Fig. 47. 



The Nervous System. 

The Xenous System consists of the brain and spinal cord., connected 
with each other, and called the cerebrospinal axis; the cranial nerves ; 
the spinal nerves and the sympathetic nerve. 

The Brain is that mass of nervous matter lodged within the skull 
bones. It is made up of three parts, — the cerebrutn^ the cerebellum^ 
and the medulla oblongata. These are nicely covered and protected 
by three membranes, the dura mater ^ the arachnoid., and the pia mater. 

Figure 47 shows a considerable portion of the brain, — the skull 
bones and membranes being re- 
moved. The scalp turned down is 
represented by a, a ; e, e, e, show 
the cut edge of the bones ; c, is the 
dura mater, drawn up with a hook ; 
r, the convolutions of the brain. 

The Cerebrum is the upper and 
larger portion of the brain, and is 
divided into two hemispheres by a 
fissure. A portion of the dura mater 
dips into this cleft, and from its re- 
semblance to a sickle, is called the 
falx cerebri. The design of this 
seems to be to support each half of 
the brain, and to prevent it from 
pressing upon the other half when 
the head reclines to one side. 

The undulating surface of the 
cerebrum is produced by what are called convolutions. The lower 
surface of this organ is divided into three lobes, — the anterior, the 
middle, and the posterior. 

The surface of the cerebrum is of a gray color, called cortical^ or 
cineritious ; the central portion is white, and is called medullary. 

The Cerebellum is about one-sixth the size of the cerebrum. It 
lies just under the posterior lobe of the cerebrum, and is separated 
from it by an extension of the dura mater, called the tentorium. It 
is composed of white and gray matter ; when the former is cut into, 
there is presented the appearance of the trunk and branches of a tree., 
called arbor dice. 




ANATOMY. 



45 



The Medulla Obloil«*ata is the top of the spinal cord ; but being with 
in the enclosure of the skull, it passes for a portion of the brain. It 
consists of three pairs of bodies, united so as to form a bulb. 

The Dura Mater is a strong, fibrous membrane which lines the 
skull and spinal column, and sends processes inward to support the 
brain, and forward, as sheaths for the nerves which go out from the 
brain and spinal cord. 

The Arachnoid is a serous membrane, and like all other serous 
membranes, is a closed sac. It is reflected upon the inner surface of 
the dura mater. 

The Pia Mater is a vascular membrane, and lies next to and invests 
the whole surface of the brain, — dipping into its convolutions. It 
furnishes nutriment to the brain. 

The Cranial IVerves which go out from the brain are in twelve 
pairs. In reading a description of them, let the reader keep his eye 
on Figure 48. 

The First Pair, olfactory (6), passes through several small open- 
ings in the ethmoid bone, and 
is distributed to the mucous 
membrane which lines the 
nose. Destroy this, and the 



Fig. 48. 




sense of smell is gone. 

The Second Pair, optic nerve 
(7), passes through the base 
of the skull, and enters the 
cavity of the eye, where it is 
expanded upon the retina. It 
is a disease of this nerve 
which occasions a gradual 
loss of sight, called amaurosis. 

The Third Pair, motores oc- 
ulorum (9), passes through the 
sphenoid bone to the muscles 
of the eye. 

Tlie Fonrtli Pair, patheticus (10), passes to the superior oblique 
muscle of the eye. 

The Fifth Pair, trifacial nerve (11), like the spinal nerves, has two 
roots, and divides into three branches, — one going to the eye, fore- 
head, and nose, and called the ophthalmic branch ; another going to 
the eye, the teeth of the upper jaw, etc., called the superior maxillary ; 
and the third going to the ear, the tongue, and the teeth of the lower 
jaw, and called the inferior maxillary. It is a painful condition of 
the branches of the fifth pair, which constitutes the terrible neuralgic 
affection called tic douloureux. 

Tlie Sixth Pair, abducentes (12), passes through the opening by 
which the carotid artery enters the cavity of the skull, and goes to the 
external straight muscle of the eye. 



46 



ANATOMY. 



The Seventh Pair, portio mollis (13), is distributed upon the inter- 
nal ear. 

The Eio'lith Pair, facial nerve (14), is distributed over the face. It 
sends nervous filaments to the muscles. 

Tlie Ninth Pair, glosso-pharyngeal nerve (14), passes through the 
same opening with the jugular vein, and is distributed upon the mu- 
cous membrane of the tongue and throat. 

The Tenth Pair, pneumogastric nerve (15), sends its branches to the 
pharynx, larynx, stomach-pipe, lungs, spleen, pancreas, liver, stomach, 
and bowels. 

The Eleventh Pair, spinal accessory nerve (16), connects with the 
ninth and tenth pairs, and is distributed to the muscles of the neck. 

The Twelfth Pair, hypo-glossal nerve (17), goes to the tongue, and 
is its motion-producing nerve. It is a nerve of great energy in those 
who talk much. 

The Spinal Cord extends from the medulla oblongata, where it is in 
connection with the brain, down to the second lumbar vertebra. The 
upper end of the cord presents a bulbous swelling, or enlargement. 
Another swelling is found where the nerves are given off which go to 
the upper extremities ; and a third near the end of the cord, where 
the nerves begin which go to the lower extremities. 

Fissures dip into the cord before and behind, and divide it into two 
lateral parts, which are united by a thin layer of white substance. 

These lateral columns are divided by furrows into anterior^ lateral^ 
and posterior columns; — the anterior being supposed to be the 
motor column, the posterior that of sensation^ and the lateral divided 
in function between motion and sensation. 

Tlie Spinal A'eiTes, connecting with the cord, are in pairs, of which 
there are thirty-one. 
Each pair has two 



Fia. 49. 



roots, 



a motor 




root, C, Figure 49, 
arising from the 
anterior columns of 
the cord, and a 
sensitive root, D, 
springing from the 
posterior columns. 

A, is a section of 
the cord, surround- 
ed by its sheath. 

B, is the spinal nerve, formed by the union of the motor and sensitive 
roots. After the union, the nerve, with its motor and its sensitive 
filapients, divides and subdivides as it passes on, and is distributed to 
the tissues of the several organs. 

The thirty-one pairs of spinal nerves are divided into eight pairs of 
cervical^ twelve pairs of dorsal^ five pairs of lumbar^ and six pairs of 
sacral nerves. 



ANATOMY. 



47 



Figure 50 gives a view of the brain and spinal cord, with the nerves 
given off by the latter : 1, 1, being the two hemispheres of the brain ; 
3, 3, the cerebellum ; 4, the olfactory nerve ; 5, the optic ; 7, the third 
pair ; 8, the pons varolii, so called ; 9, the fourth pair ; 10, the lower 
portion of the medulla oblongata; 11, 11, the spinal cord; 12, 12, 
the spinal nerves; 13, 13, the brachial plexus; 14, 14, the lumbar and 
sacral plexus. 

Fia. 50. Fig. 51. 





The Brachial Plexus is formed by the interlacing of the four lower 
cervical and upper dorsal pairs of nerves. It gives off six nerves, 
which are distributed to the muscles and skin of the upper extremities. 

The Lumbar aud Sacral Plexus is formed by the last dorsal and five 
lumbar nerves, from which nerves go to the muscles and skin of the 
lower extremities, and the last lumbar and four sacral, from which 
nerves are sent to the muscles and skin of the hips and lower extremi- 
ties. 

The Sympathetic Nerve consists of a series of knots (ganglia), lying 
along on each side of the spinal cohunn, and forming a knotted chain. 
There is a knot for each intervertebral space, the neck excepted. These 
knots are composed of both cineritious and medullary matter. 



48 



ANATOMY. 



Each knot is a distinct centre, and gives off branches upward, 
downward, externally, and internally. AH the internal organs are 
supplied with branches from the sympathetic nerve. It is called the 
nerve of organic life, and is supposed to preside over nutrition, secre- 
tion, etc., as the nerves of the brain and cord preside over motion and 
sensation. 

Figure 51 is a fine representation of the great sympathetic, with 
its knots, and connections with other nerves. A, A, A, is the semilu- 
nar ganglion and solar plexus, lying just under the diaphragm and 
behind the stomach. Its presence in this region is the reason w^hy a 
blow upon the pit of the stomach sometimes destroys life. D, D, D, 
are the thoracic ganglia ; E, E, the external and internal branches 

of the same ; G, F, the right and left coro- 
nary plexus upon the heart ; I, N, Q, the 
inferior, middle, and superior cervical gan- 
glia ; I , the renal plexus around the kid- 
neys ; 2, the lumbar ganglion ; 3, the inter- 
nal branches ; 4, the external branches ; 5, 
the aortic plexus. 

Figure 52 represents a plexus, showing 
how the filaments of one nerve pass to be enclosed in the sheath of 
another. In this way they change at once the direction of their jour- 
ney, and their companions upon the way. 




Fig. 53. 



The Organs of Sight. 

The organs of vision are the optic nerve^ the globe of the eye^ the 
muscles of the eye, and the organs of protection. 

The Optic jVerve begins by two roots at the base of the brain, the 
fibres from each of which meet, as they 
come forward, and some of them cross 
each other. The two nerves then sepa- 
rate, and enter the back part of the 
globe of the eyes, and then spread out 
into a kind of membrane. In Figure 
53 : 1, 1, show the globe of the eye ; 
2, the crossing of the optic nerve ; 8, 
the origin of two pairs of cranial nerves. 

The Globe of the Eye is a better con- 
structed optical instrument than man 
ever made. Its interior is filled with 
what are called refracting humors or 
mediums, which are surrounded and held in their place by membranes, 
called coats. 

The Coats are the sclerotic and cornea; the choroid, iris, and ciliary 
processes ; and the retina. 

Tlie Sclerotic Coat is a fibrous membrane, covering the largest portion 




ANATOMY. 



49 



of the globe. To this the muscles are attached. It is the part which 
is called the white of the eye. It has a beveled edge in front, into 
which the cornea is fitted. 

The Cornea is a transparent layer which projects in front, and forms 
about one-fifth of the globe. It is shaped like a watch glass. Its 
blood-vessels are too small to receive the red particles of blood. 

The Clioroid Coat is a vascular membrane. Its color is brown exter- 
nally, and black within. It is connected with the sclerotic coat ex- 
ternally, and internally with the retina. It is composed of three 
layers. 

The Iris is named from its having a variety of color in different 
persons. It is the partition between the anterior and posterior cham- 
bers of the eye, and has a circular opening in the centre called the 
pvpil. Of' its two layers, the fibres of the anterior one are radiating, 
and dilate the pupil, while those of the other are circular, and cause 
its contraction. 

The Ciliary Processes are a number of folds formed from the inter- 
nal layer of the choroid coat. 

The Retina has three layers. The external is extremely thin ; the 
middle is nervous, being an expansion of the optic nerve ; the 
internal is vascular, and consists of a ramification of minute blood 
vessels. 

The divided edge of their coats, may be seen in Figure 54, 
namely, the sclerotic, the choroid, and the retina ; 2, is the pupil ; 3, 
the iris ; 4, the ciliary process ; 5, the scolloped border of the retina. 



Fig. 55. 




Tlie Humors of the Eye are the aqueous, the crystalline, and the 

vitreous. 

The Aqueous or watery humor is. situated in the chambers of the 
eye. It is an albuminous fluid, with an alkaline reaction, and a spe- 
cific gravity a Httle greater than distilled water. 

7 



50 



ANATOMY. 



The Cryst;illiiie Humor is immediately behind the pupil. It 
lens^ and is convex both on the posterior and the anterior surface. 



IS a 




The Viti'eous Huinor is also an albuminous fluid, something like the 
aqueous humor, but more dense. 

In Figure 5^ we have in E a good view of the cornea fitted into 
the sclerotic coat; A, is the choroid; B, the pigmentum nigrum ; C, 
the retina ; K, the vitreous humor ; D, the optic nerve ; I, the lens ; 
G, the iris, painted on the back side with pigment ; F, the aqueous 
humor. 

The muscles of the eye, six in number, are attached to the bones 
of the orbit behind, and to the cornea in front, by their tendons. 
These tendons give the eye its pearly appearance. In Figure 
6^^ five of the muscles are indicated by a, 5, c, d^ e ; /, is the optic 
nerve. 

If the internal muscle be Fia. 56. 

too short, the eye is drawn I 
in towards the nose, and the| 
squinting called " cross eye " 
is produced. 

The Orhits are bony sock- 
ets which enclose the eye. The I 
optic nerve passes through a 
large hole at the bottom. 

The Eyebrows are the pro- 1 
jecting arches above, covered 
with short hair. They prevent the sweat from running down into the 
eyes, and also shade them from strong light. 

The Eyelids are the curtains which rise and fall in front. The 
smooth membrane which lines them, is called the conjunctiva. It 
secretes a fluid which makes the eylids open and shut easily. 

The Lachrymal Glaml is at the upper and outer angle of the orbit. 
Several small ducts open from it upon the 
upper eyelid, through which the tears run down 
upon the conjunctiva. 

The Lachrymal Canals begin near the inter- 
nal angle of the eye, by two small tear points, 
which communicate with the sac at the upper 
part of the nasal duct. 

The ^'asal Duct is a canal about three quar- 
ters of an inch long, which runs down to the 
inferior channel of the nose. 

Figure 57 shows these organs : 1, being 
the lachrymal gland ; 2, the ducts leading 
to the upper eyelid ; 3, 3, the tear points 
(pun eta lachrymalis) ; 4, the nasal sac ; 5, the termination of the 
nasal duct. 



Fig. 57. 




ANATOMY. 



Ol 



The Organs of Hearing. 

Tlie External Ear is composed of the pavilion of the ear (the pinna), 
and the auditory canal (the meatus auditorius externus). 

Tlie Pinna surrounds the entrance to the auditory canal. It stands 
out from the head, and is in common language called the ear. 

The Meatus Auditorius is a canal about an inch long, partly bony 
Fig. 58. and partly cartilaginous, which 

goes from the pavilion of the ear 
to the drum of the ear. 

The Drum of the Ear (mem- 
brana tympani) is an oval-shaped 
thin membrane, inserted into a 
groove around the auditory ca- 
nal. 




The Tjmpanuni is a cavity 
within the temporal bone. 

The Eustachian Tube is a chan- 
nel of communication between the 
tympanum, and the upper part of 
the pharynx. The object of this 
is to convey air to the drum of 
the ear, as without air, no sound can be produced. 

The Labyrintli is a series 
of chambers through the 
petrous bone, — embracing 
the vestibule a three-cornered 
cavity within the tympanum ; 
the ^emi-circular canals^ com- 
municating with the vesti- 
bule, and the cochlea^ which 
makes two and a half turns 
around an axis, called the 
modiolus. 

In Figure ^"^^ «, is the 
pavilion of the ear; c, the 
auditory canal ; «-, the mem- 
brana tympani ; k^ the tym- 
panum ; e^ the bones of the 
ear ; h^ the semicircular ca- 
nals ; /, the cochlea ; //, the 
vestibule ; {, the eustachian tube ; d^ the auditory nerve. 

In Figure 59, we have a view of the labyrinth laid open, and 
highly magnified: 1, 1, being the cochlea; 2,3, the channels that 
wind around the central point (5); 7, 7, the vestibule ; 8, the Ibranicn 
rotundum ; 9, the fenestra ovalis ; 4, 6, 10, the semicircular canals. 




PHYSIOLOGICAL LAWS OF LIFE AND HEALTH....HYGIENE. 



Life, the Infancy of Being. 

It may be stated as a general truth that man has but just learned 
to live when he is ready to die. We expend a large portion of our 
lives in searching out our mistakes, and in striving to undo the mis- 
chiefs they have occasioned. This is true in reference both to our 
moral and our physical life ; and I draw from it the conclusion that 
the present must be only the infancy of our being, and that our blun- 
ders and consequent sufferings here, will cause us, in the great here- 
after, to place a higher value upon knowledge, and to struggle with 
new fortitude to rid ourselves of every bondage. 

A life which has just begun to take shape and symmetry, cannot 
be permitted, I think, under the rule of a benevolent Creator, to be- 
come extinct. "We shall certainly be permitted to take up the broken 
thread of life, and, in the clearer light of the future, with the warning 
experience of the past, and surrounded by better guards, to try again. 
In the mean time, while here, the sooner we become acquainted with 
the laws of life, and the better we obey them, the more we shall en- 
joy- 

The Nervous System. 

Man is brought into connection with the outward world through 
the senses of feeling, seeing, hearing, etc. These communicate with 
the brain and mind through the nerves of sensation. 

The nervous system is divided into two great central portions, 
the brain and the spinal cord ; and these together are called, by the 
learned, the cerebrospinal centre. There are numerous pulpy white 
cords, called nerves, which at one end are connected with this great 
axis or centre, and from thence run to all parts of the system. A 
portion of these nerves start from the base of the brain and run to 
the eye, the ear, the tongue, etc. (Fig. 48.) ; while another, and a 
larger part spring from the cord which runs through the back-bone, 
and are distributed over the body, and the lower extremities. (Figs. 
50 and 60.) One portion of these cords produce feeling ; another 
part, motion. The jformer we call sensitive ; the latter, motor. Both 
kinds are widely distributed over the body. Those which spring 
from the spinal cord have two roots, one uniting with the back^ the 



HYGIENE. 



53 



Fia. 60. 



other with the front part of the cord. Cut off the back root, and the 
part to which it is distributed loses its feeling. As we say in com- 
mon language, it be- 
comes numb, though it 
may move as well as 
before. Cut the front 
root, which is motion- 
producing, and the part 
to which it goes cannot 
move. It is palsied, 
though it may still feel 
acutely. The numerous 
nerves that spring from 
the spinal column are 
pretty well represented 
in cut 60. 

If the cranial nerves 
of motion which go to 
the face be cut, no emo- 
tion or passion can be 
expressed. The features 
will all be immovable, 
like statuary. To smile, 
to laugh, to frown, to 
give expression to the 
feeling of pity, or an- 
guish, or love, is alike 
impossible. And yet a 
breath of air upon the 
face w^ill he felt as readi- 
ly as before. Paralysis, 
or palsy, as it is called, 
partial or general, is the 
result of injury upon few 
or many of these motion- 
producing nerves. Neu- 
ralgia, tic douloureux, 
etc., arise from some dis- 
ease, perhaps inflamma- 




tion, of the nerves of 
sensation. 

How the Mind Gets Knowledge. — Everything the mind knows of 
the external world, it learns through the organs of sense, which com- 
municate with it through these nerves. Thus, the nerves are acted 
on by external agents, and then they act on the brain and cause sen- 
sations. When the hand is bi^rned, the nerves of sensation run with 
the intelligence to the brain, which, quick as thought, through the 
nerves of motion, despatches orders to the muscles to repel the 
injury. 

Coiiiparisoii. — The arrangement and operation of the nervous sys- 



54 HYGIENE. 



tern are like those of the electric fire-alarm system of Boston. The 
brain is the intelligent centre, like the central office at City Hall. The 
nerves of sensation which carry to the brain, with electric speed, in- 
telligence of what is going on outside, are like the wires which run 
to the City Hall from the several station-boxes. The quick carrying 
to the brain of any information of injury done to some part of the 
body, is like sending to the City Hall from a station-box the intelli- 
gence of fire in one of the districts. The rapid transmission of orders 
from the mind to the muscles, is like flashing the alarm over the wires 
to every part of the city. And, finally, the powerful action of the 
muscles in warding off danger, is like the dashing of firemen over the 
pavements, and the energetic plying of the engines. 

Sensations. 

An effect, produced on the mind through a nerve, is called a sensa- 
tion. Hunger is a sensation. It is an effect produced upon the mind 
through a certain nerve by the condition of the stomach. Thirst, 
pain, heat, cold, are sensations in a similar sense. Nausea is a sensa- 
tion produced by some injurious substance acting upon the coats of 
the stomach. 

Sti'eng'tli of Sensation. — Some sensations are much stronger than 
others ; some are very intense. A very strong sensation is called a 
feeling. It is common to say, " I feel cold," or, " I feel hot." We 
simply mean by this, that the temperature of the weather makes a 
very powerful impression upon us. 

Kinds of Sensation. — Sensations are either pleasurable or painful. 
Pleasurable sensations arise from the proper exercise of some healthy 
part of the body ; and they are a suitable reward for any care the 
mind may take of the corporeal organs. 

The sensations arising from a proper amount of exercise are pleas- 
urable. The muscles find a sort of enjoyment in action. He who 
leads a sedentary life, either from choice or necessity, loses much enjoy- 
ment. Hence there is pleasure in labor ; and the working man, 
though often pitied by the wealthy, is generally the happiest of men. 
The eye and the ear, when directed to agreeable sights and sounds, 
derive the most agreeable sensations from exercise. The air of a 
beautiful spring morning gives impressions which none can describe, 
but which all know to be delightful. These impressions are well 
fitted to reward us for taking at that season, in the open air, the ex- 
ercise we so much need. 

Moral Uses of Sensations. — How little we reflect upon the amount 
of happiness it is in our power to create by making agreeable impres- 
sions upon others. A civil and polite address makes a pleasant im- 
pression. A kind word, fitly spoken, makes the heart glad. Heads 
of families might do much to increase the happiness of their domes- 
tics in the kitchen by meeting them with a pleasant countenance, and 
dropping in their ear, now and then, a word of approval. Such little 



HYGIENE. 55 



acts of benevolence are easily performed, and they make the most 
agreeable and lasting impressions upon persons in the lower stations 
of life, — creating attachments, in fact, which end only with death, 
and which in hours of future sorrow, which come to all, may refresh 
us like springs of water in the desert. 

Full many a shaft at random sent, 
Finds mark the archer little meant ; 
Full many a word at random spoken, 
May heal a wounded heart that 's broken. 

Walter Scott. 

In aiming to make agreeable impressions upon domestics, we should 
be governed by the simple desire to create happiness. Their sources 
of happiness are comparatively few. They spend their days below- 
stairs, — shut out from a portion of the light of day, and from the 
refining influences of the drawing-room, — having little time for rest 
or for recreation. How unfeeling to treat such persons with harshness, 
to wear a frowning face in their presence, and thus wither the few 
flowers of happiness which bloom around them I 

Every human being is endowed with the beautiful nervous organ- 
ism of which I have spoken, and is daily receiving impressions, pleas- 
urable or painful, from thousands of sources. In all the relations of 
life, it should be our aim to touch delicately this sensitive structure. 
Wives may add much to the happiness, and I may say, to the affec- 
tion of their husbands, by always wearing a pleasant face ; and the 
heart of the wife may be made light and glad by gentle words from 
the husband. We cannot but love those who make pleasurable im- 
pressions upon us, and we necessarily dislike such as impress us pain- 
fully. Most of the coldness and alienations which grow up between 
the heads of families, spring from the habit, of one of the parties, of 
saying, or doing, or looking something which painfully impresses the 
other. A woman who habitually wears a " sour " face, cannot be 
loved either by her husband or her children. The man or the woman 
who desires to be loved, must cultivate a manner, a look, a speech, a 
life, the whole scope of which is fitted to make pleasurable impres- 
sions upon others. It is against nature to love what gives us pain. 

AgTecable Sensations, a Source of Health. — Pleasurable sensations 
not only beget love, and increase happiness, but they add much to 
health. They exhilarate the spirits and drive away melancholy. 
Travelling promotes health and prolongs life, by the number and 
variety of the pleasing impressions it makes upon the mind. 

Care of the Sick. — If the above statements be correct, how im- 
portant that the sick should be so dealt with as to have none but 
agreeable sensations made upon them. Many a life has been sacri- 
ficed to the peevish temper of a nurse. When the nerves are woalc 
from disease, even slight causes make powerful impressions ; and if 
these impressions are of a painful kind, the results are most deplora- 
ble. To treat harshly the sick, especially those whose nervous system 
is broken, implies either great thoughtlessness, or extreme cruelty. A 



56 HYGIENE. 



single harsh word, which would scarcely move one when well, may 
send the same person, when sick, almost to distraction. Every word 
spoken to persons in sickness should, therefore, be gentle and sooth- 
ing. Every feature of the face should express either cheerfulness, 
or tenderness and pity. 

As the painful impressions, which disease is making, tends to de- 
press the spirits and create melancholy, it is not expected that persons 
when sick will exhibit as amiable tempers as when well ; and for 
this, all due allowance must be made. 

Effect upon the Disposition. — This leads me to say that pleasura- 
ble sensations improve the temper and disposition. This is a fact of 
very great importance, and parents should never lose sight of it in 
dealing with their children. There are few children but would grow 
up amiable and useful members of society, were they dealt with in 
the gentle and tender manner which their young and impressible 
natures require. From the moment the young mind wakes to intel- 
ligence, it will be occupied with something. Parents and guardians 
should aim, therefore, to turn it to all those things which will impress 
it pleasantly, and at the same time do it no harm. Exercise, songs, 
playthings, flowers, — to these and other entertainments it should be 
led by gentle hands. No thoughtful parent will ever pain a child by 
harsh threats and denunciations, or shock it by an oath. 

Bad Effect of Unpleasant Sensations. — If pleasurable sensations 
improve the health and temper, unpleasant ones do just the opposite. 
They break down the health, and spoil the disposition. 

They are intended to give us a warning of impending injury. 
Thus, we have painful sensations when we have overworked the body 
or mind. The sensation of weariness tells us that the muscles have 
worked as long as their good requires, and that they need rest. Were 
this sensation unheeded, exhaustion and entire prostration would be 
the result. 

When fatigue begins to be felt, either of body or mind, the sensa- 
tion may be dissipated by strong tea, or intoxicating drink, or opium ; 
but to drive it away in this manner, for the purpose of working longer, 
is wrong, and leads, in the end, to disease or exhaustion. It is said 
that one of the most brilliant advocates of our time is dependent 
upon opium for the stimulus to carry him through his extraordinary 
flights of eloquence ; but his restless motion and nervous face remind 
us that he has bent his bow very nearly to the snapping point, and 
that a sudden collapse of his vital powers, at no distant day, may 
be feared as the result of such tension. 

Persons in affliction, whose spirits are depressed and broken by 
sorrow, should have their thoughts turned away from all sombre ob- 
jects and contemplations. They should be taken into the open sun- 
light, and be diverted by the beautiful things of nature. They should 
visit cheerful society, and open their hearts to pleasurable impres- 
sions. 

When we permit any part of the body to remain idle, neglecting 
to use it as much as we ought, unpleasant sensations remind us of 



HYGIENE. 57 



our fault. The muscles, when unused, waste away and become feeble. 
This is sure to produce an uneasy, nervous state of feeling, which 
says to us as plainly as a sensation can, that the muscles are hungry 
for exercise, and that it is injurious to let them rest longer. 

Need of a Healthy Brain. — In order that we may get correct ideas 
of the external world, it is necessary that the brain, the nerves, and 
the organs of sense through which sensations are made upon the 
raind, should be in a healthy condition. It is evident that if the in- 
struments of sensation be diseased, the sensation cannot be natural, 
and will make a false report to the mind. It is of the highest impor- 
tance, therefore, that the brain should be sound. 

Improper Intermarriages. — This organ, like every other, may in- 
herit disease from parents. Insanity, which springs from a diseased 
brain, is often hereditary. When both parents are diseased, the off- 
spring are of course more liable to partake of their defects. Among 
the wealthy, and particularly among the royal families in Europe, 
nervous diseases and sterility are very common. This arises, in a 
great part, from intermarriages among blood relations, — a practice 
under which any people will degenerate, and finally perish. The 
wisdom of the Old Testament prohibition of marriage within certain 
degrees of consanguinity, has been established by the observations of 
philosophers, and the experience of mankind. When a man commits 
the folly of marrying his first cousin, he generally either has no issue, 
or his children are afflicted with deafness, or some shocking form of 
nervous disease. Let those who will transmit to their descendants a 
sound mind in a sound body, observe the laws of life, and avoid all 
marriages with blood relations. 

Bfeed of a Good Supply of Blood. — For a proper performance of 
its duties, the brain requires and receives a larger supply of blood 
than any other part of the system. One tenth of all the blood goes 
to this important organ. If the quantity or quality be materially 
lessened or changed, great disturbance of the brain follows. A large 
loss of blood occasions dizziness and fainting. If an atmosphere 
charged with too much carbonic acid gas be breathed, as in a deep 
well, the blood is not vitalized in the lungs, so as to sustain the brain, 
and unconsciousness soon follows. If the air be vitiated in any way, 
or have its oxygen extracted, as in large assemblies, where it is 
breathed over several times, it becomes unfit to support the brain, and 
the result is languid feelings, inability to apply the mind, headache, 
fainting, hysterics, and other nervous manifestations. 

Ventilation. — This shows the great necessity of having dwellings, 
churches, and school-houses well ventilated. 

Were a good system of ventilation adopted in all our churches, 
ministers would seldom preach to sleeping audiences. A congrega- 
tion sitting in one of our places of public worship, where the air in a 
single afternoon is as many times used over as the minister's sermons 
are in a lifetime, can neither hear with attention, nor comprehend wi:h 
clearness. 

8 



58 HYGIENE. 



In our school-houses, the ventilation is quite as bad, and the conse- 
quences worse, because they are occupied six hours in the day instead 
of three, and six days in the week in place of one. In the small school- 
houses which our children filled to overflowing in former years, in 
which there was no ventilation, unless they happened to be blessed 
with an old-fashioned chimney and fire-place, the effects upon the 
nervous system of the children was deplorable. Many of the dis- 
eases which afflict the present generation of men and women, had 
their origin in the bad air of those crowded nurseries of education. 

Our dweflings were partly ventilated in olden time, when the open 
fire-place received the " back-log," the " top-stick," the " fore-stick," 
and other sticks to match ; but since we have been warmed by the 
stove and the furnace, we have known little of the luxury of pure air 
at the domestic hearth. 

Need of Exercise for the Briiiii. — Health requires that the brain 
should be properly occupied with vigorous thought. The same rea- 
sons may be given for this as for the exercise of the muscles. It is 
governed by the same laws which apply to other parts of the system. 
Use improves its strength and vigor, — idleness causes it to grow 
feeble. Of course the labor it is put to should be only reasonable in 
amount, and should not be too long continued at any one time. 
With the weakening of the brain, the whole bodily forces, and indeed 
the whole mental and moral character, fall into feebleness and decay. 
It is a great mistake to suppose that the cultivation and even vigorous 
use of the mind, impairs health and shortens life. Just the opposite 
is true. Many of the most eminently intellectual men, who have 
worked their brains hard all their lives, have been distinguished for 
long life. 

Bad Effects of Change in Circumstances. — No class of persons 
suffer more from nervous diseases and general ill health, than those 
who, having worked hard in early life, with little or no cultivation of 
the mind, are suddenly raised to wealth, and immediately drop all 
exercise, and fall into habits of indolence and luxury. The condition 
of such persons would be much less pitiable, did they take up books 
when they lay by the hoe or the broom. But they seldom do this. 
Many a woman, in early life, has felt the glow of health in every 
limb, and a thrill of pleasure, too, while scrubbing the floor upon her 
hands and knees, who has, in subsequent years, reclined in miserv 
upon her damask-covered lounge, and wondered that she could not 
have the health of other days. Let her cultivate her brain, live tem- 
perately, and exercise in the open air, and life may again have real 
pleasures for her. 

Discretion in Exercising the Brain. — In exercising the brain we 
must use discretion. We must not sit down in the morning, and ply 
it with work during the whole day, without rest. This would soon 
bring upon it disease, or premature decay. It should be worked only 
until it begins to show symptoms of fatigue. Then it should be per- 
mitted to rest ; or, what is better, be turned to some new subject, of 



HYGIENE. 



a lififhter, or a different character. This often rests the brain better 
than to entirely suspend its action. 

Overworking' the Brain in Childhood. — Great care should be used 
not to exercise the brain too much in early life. Like other parts of 
the system, it is tender in childhood, and will not bear prolonged ex- 
ertion. As a general thing, children are put to school too early, and 
made to work their brains too hard. Great mischief arises from this 
source. Children are born with larger brains now than formerly ; and 
it is no uncommon thing to see upon a child of ten years, a head 
equal in size to that of an adult. Children run to brain. Precocity 
in development of brain and mind is common. The results of stim- 
ulating and hastening the unfolding of such minds are deplorable. 
In such children, the brain should be the last thing to be cultivated. 
We need not urge its growth. It will come forward fast enough in 
spite of us. Our chief aim should be to harden and fortify the general 
constitution, so that the noble brain which it is required to bear up 
and sustain, may long be its crown and glory. 

Yet parents are proud of their precocious children, and often revrr^^e 
this rule. They do it thoughtlessly, and would be terribly startled, 
could they suddenly look into the future, and see the results of their 
folly. Could they do so, they would see inflammation and softening of 
the brain, epilepsy, insanity, paralysis, apoplexy, with all the horrors 
of undescribed and indescribable nervous affections, which, though 
without a name, have a terrible reality. 

Old People's Brains. — Persons in advanced life should be particu- 
larly careful not to overwork the brain. In middle life it recovers 
easily from great fatigue. In the decline of life, its powers of recov- 
ery are feeble. A single exhaustion may cause its fatal collapse. Old 
age should be distinguished for gentleness and moderation. The 
journey of the down-hill of life should be made by short and easy 
stages, through regions of diversified beauty. 

A Supply of Blood. — Every part of the system, when hard at work, 
needs and must have a very large supply of pure blood. Without 
this, it is torpid and inactive. To cause the blood to flow to any 
particular part, it must be exercised. The lumberman, when in the 
forest in extreme cold weather, stamps his feet violently upon the 
ground, or beats them against a log, and whips his hands around his 
body ; and in this way makes them red and warm with a new supply 
of blood. The stomach, when it has received a supply of food, be- 
gins earnestly to turn it over; and by this exercise, and the stimulus 
which the food supplies, it invites large quantities of blood to its 
vessels, and thus increases its power to work. But just in proportion 
that it draws the vital current to itself, and augments its own vital 
force, it diminishes the blood in other org-ans, and, for the time being, 
unfits them for work. The same may be said of the brain and all 
other working organs. 

From this it follows that only one organ, or set of organs, can work 
efleetively at the same time, and that it is improper to put the brain 
to hard work immediately after a full meal, because the stomach then 



60 HYGIENE. 



wants 'the blood to enable it to digest the food ; and if the blood be 
called oft* to the brain, digestion will stop. Nor should the stomach 
be loaded with food directly after long and hard thinking ; for the 
brain will yield up the blood to it only after its own excitement has 
had time to subside. 



Sympathetic Nervous System. 

The object of this system seems to be to bind all parts of the body 
together, and to combine and harmonize their actions. It takes care 
that no part of the system acts in such a way as to injure any other 
part. It exerts a controlling influence over digestion, nutrition, ab- 
sorption, the circulation, etc. These are natural processes which 
need to go on while the brain is asleep and cannot attend to them. 
The nervous system, of which I speak, presides over all those func- 
tions which are called involuntary, — so called because no act of the 
will is needed for their performance. Secretion, absorption, digestion, 
and the circulation of the blood, all have to go on while we sleep, as 
well as while we wake. Were an act of the will necessary to their 
performance, as in walking, eating, conversing, etc., then they would 
have to cease the moment the brain fell asleep, and death would be 
the result. 

The sympathetic nerves apprize each part of the system of the 
condition and wants of every other part. When the lungs are in- 
flamed, the stomach seems to be aware of it, and will receive no food, 
because this would aggravate the disease of the neighboring organs. 
Well would it be if human beings would exercise a like forbearance, 
and abstain from those acts of self-gratification which they know will 
injure their neighbors. 

Effects of Xervous Diseases. — Before closing these observations, I 
wish to add a few words respecting the terrible effects of nervous dis- 
eases which characterize the present time. 

That they are far more numerous and aflflictive than in former 
years, must be apparent to the most careless observer. They are 
nothing more nor less than the price we pay for a high civilization, 
and especially for our republicanism. Among us, every man feels his 
individuality, and has a motive for thinking and doing his best. 
Thought and action are here unfettered ; and if the race is not to 
the swift, nor the battle to the strong, every man acts as though he 
thought it was. The great excitement which the struggle for wealth 
kindles and inflames, deranges and shatters the nervous system to a 
shocking degree. 

And weahh, when obtained, does its full share to weaken the nerves. 
It brings with it high living, indolence, loss of energy, dissipation, and 
a weakening of the whole moral and physical powers. It need not 
do this; but, in most cases, it does. 

The result is, that, at least, every other person has some nervous 
disease, which makes life a misery rather than a blessing. The brain 
and nerves are too much developed in comparison with the develop- 



HYGIENE. 61 



ment of the muscles. Half our boys and girls have heads as large 
as men and women. It is common to see a boy or a girl at ten talk- 
ing and acting like a man or woman. I do not mean by this, that 
they imperfectly imitate the actions of older persons. It seems to be 
natural to them. Their brains are prematurely developed, and their 
acts and thoughts have the maturity of adult life. 

What is Coining:? — What will be the result of this state of things, 
no man can predict. I sometimes think the race will break down ; 
that that which was intended to be its ornament and strength, will be 
its destruction. I hope not. Yet there is danger of it. Nothing cm 
save us but the wisdom to adopt such means as w^ill develop all parts 
of the system alike. No race of men can stand for many generations 
such a strain upon the nervous system, unless better means are adopted 
to counterbalance its evil effects than are now used in the United 
States. We have got to pause in our swift career, and look after our 
health, or we shall become a nation of maniacs. No proof is needed 
of what is here said. There is scarce a man or a woman but has 
in their own person the foreshadowing evidence of our impending 
doom. 

Hopefiil Considerations. — It is proper to say the considerations 
here presented, terrible as they are, are mitigated in some measure by 
others of a more hopeful character. 

Physiology and the laws of life are now better understood than at 
any former period. These subjects are getting into our common 
schools, and are engaging the attention of our youth. Declining 
health has already made us think more of the means of preserving 
it, — such as diet, exercise, bathing, travelling, and amusement. To 
encourage and intensify this hopeful direction of the public mind, I 
propose to devote a few pages to these subjects. 

Food and Digestion. 

From the earliest dawn of existence to the last moment of life, our 
bodies are constantly changing. Old particles of matter, when they 
are worn out, leave their places and are thrown out of the system. 
Were this the whole of the matter, our bodies would soon waste 
away, and that would be the end of us. But as fast as the old mate- 
rials are thrown away, new ones take their places ; and it is solely 
out of our food that these new materials are formed. 

In order that the food may be well digested, it must first be broken 
into small particles in the mouth. The act of chewing it, is called mas- 
tication. During this act, if it be well performed, a large quantity of 
spittle, called saliva, flows out of a number of glands, called salivary 
glands, and mixes w^ith the food, forming wdth it a soft mass. In this 
condition, it is thrown backward into the top of the throat, called the 
pharynx. Here, a little cartilage, called the epiglottis, drops down 
upon the opening into the top of the windpipe, and prevents its en- 
trance into the breath passage ; and it is pushed along into the gullet, 
a tube which runs down behind the windpipe and lungs, and which 



62 HYGIENE. 



physicians call the oesophagus. Here a succession of niuscular bands, 
in circular shape, contract upon it, one after another, and force it 
down into the stomach. 

It is important that two things should be secured while the food is 
in the mouth, namely, that it should be reduced to a good degree of 
fineness by chewing, and that a proper amount of saliva should be 
mixed with it. If the chewing were not necessary, teeth would not 
have been given us ; and the salivary glands would certainly not have 
been put in the vicinity of the mouth, if the mixing of water wdth our 
food would serve the purposes of digestion as well. 

Eiitiiij? too Rapidly. — The Americans have, fallen into a pernicious 
error in eating their food too rapidly. Time is not given to chew it 
sufficiently to excite a full flow of saliva ; and as it cannot be swal- 
lowed in a dry state, it is not uncommon to see persons taking a sip 
of water after every second mouthful to enable them to force it into 
the stomach. It is a habit we Americans have of cheating ourselves 
both of the pleasures and the benefits of eating ; for the only real 
pleasure of eating arises from the flavor of food while retained in the 
mouth, and the only benefit we can derive, comes in consequence of 
its proper digestion. 

The food when received into the stomach is in the same condition 
as when taken into the mouth, except that it is, or should be, ground 
fine by the teeth, and well mixed with saliva. 

The Gastric Juice. — The stomach, like the mouth, the windpipe, 
and the gullet, is lined by a mucous membrane. The chief office of 
this membrane is to secrete, or take out of the blood, a fluid which 
we call gastric juice, which means stomach juice ; for the Greek name 
of stomach is ^yaarrjp (gaster). This fluid has not much smell or 
taste, and looks like spring water. It has a powerful effect upon food, 
which, when mixed with it, soon undergoes an important change, 
which is apparent to the taste, the smell, and the sight. What the 
nature of the gastric juice is, or how it produces its eftect upon food, 
is not certainly known. 

Too ^luch Cold Water at Meals. — There are some interesting facts 
connected with the formation of this fluid, of which it is important 
that every person should be apprized. 

Its quantity and quality depend on the amount and healthfulness 
of the blood which flows to the stomach during the first stage of 
digestion. It is, therefore, injurious to drink large quantities of very 
cold water with, or immediately after, our meals ; as this will chill 
the stomach, and repel the blood from its vessels, so that but fittle of 
the juice can be formed. Digestion, in such case, must be imperfect. 

This Fluid not Secreted Without Limit. — This fluid does not flow 
^into the stomach continuously, but only when we swallow food, and 
then, not as long as we please to eat, but merely till we have taken 
what the system requires. If, in the amount we take, we go beyond 
the wants of nature, there will not be fluid enough formed to dissolve 
it, and the whole will be imperfectly digested, and be a source of in- 



HYGIENE. 63 



jury rather than benefit. This should teach us to be careful that our I 
food be only reasonable in amount. ^ 

Xot Secreted in Sickness. — When we are sick, the gastric juice is 
either not formed at all, or only in small quantities. Whatever may 
be our feelings of lassitude, and however much we may appear to 
need food, at such times, it is useless to take it, for it cannot be di- 
gested, and will only aggravate our disease. If the illness be only 
slight, the fluid will be formed to some extent, and food may be taken 
in proportion. 

Its Secretion Favored by Cheerfnlness. — A cheerful disposition, and 
a happy, lively frame of mind, are highly favorable to the production 
of the gastric juice ; while melancholy, and anger, and grief, and 
intense thought of business at the hour of meals, greatly hinder its 
natural flow. 

This' should teach us to go to our meals with light hearts, and to 
make the family board a place of cheerful conversation, and of a light 
and joyous play upon the mirthful feelings of all present. Should 
any of the family circle be in the habit of using vinegar as a condi- 
ment, we should never be guilty of compelling them to extract it from 
our faces. A vinegar face is not easily excused anywhere ; at the 
table it is unpardonable. A single countenance of this description 
will throw a gloom over a tableful of naturally cheerful persons; and 
if habitually present at the board, may finally spoil the digestion of 
half a dozen, and entail dyspepsia upon them for life. 

The stomachs of the sick pour out but very little of this fluid, and 
they can take but a small amount of food. It is cruel to deprive them 
of the power of digesting that little by treating them harshly, and 
filling them with gloomy and desponding feelings. I, therefore, repeat 
the substance of the advice given on a previous page : Deal gently 
with the sick. 

IIow all this is Known. — As the stomach is wholly concealed from 
view, the reader will very naturally ask how it is known that the gas- 
tric juice is poured into it in certain states of the mind, etc., and with- 
held in others. It certainly could not have been so accurately known, 
had it not been for an accident which opened the living and working 
stomach to the inspection of Dr. Beaumont, a United States Surgeon. 
A young man by the name of Alexis St. Martin, a Canadian by birth, 
but then in the State of Michigan, had a large part of his side torn away, 
and a hole of considerable size made into his stomach, by the acci- 
dental discharge of a gun. To the surprise of his surgeon, St. Martin 
recovered ; and the edges of the wound in the stomach refused to 
grow together, preferring rather to fasten themselves to the borders of 
the breach in the side, thus leaving the passage open. A kind of cur- 
tain grew down over this, which prevented the food from falling out. 
Dr. Beaumont, taking advantage of this state of things, instituted a 
series of valuable experiments, by lifting the curtain, and inserting 
various articles of food, and witnessing the process of digestion. 

Movement of the Stomach. — The presence of food in the stomach 



64 HYGIENE. 



causes its muscular coat to contract and throw it about from side to 
side, mixing it thoroughly with the gastric juice, and reducing it to a 
pulpy mass, called chyme. This, as fast as it is properly prepared, 
passes through the pylorus into the upper bowel, or duodenum^ called 
also the second stomach. 

Chyme, — A certain witty professor of anatomy and physiology, is 
in the habit of asking his class if they ever saw any chyme; and 
when they answer no, as they often do, he calls their attention to 
what they occasionally see in the morning, upon the sidewalks, where 
drunken men have held themselves up by lamp-posts, and left the 
contents of their stomachs. 

The pylorus, or opening into the bowel, has a very singular and 
wise instinct, which is worthy of remark. When a piece of food, 
which has not been digested, attempts to pass into the bowel, the 
momenc it touches the inner surface of this orifice, it is instantly 
thrown back by an energetic contraction ; though a portion of well- 
prepared chyme touching the same opening immediately after, is 
allowed to pass on unchallenged. 

Chyle, — The chyme, when it reaches the duodenum, seems to cause 
the liver to secrete bile, and the pancreas to produce the pancreatic 
juice. These two fluids are conveyed into the upper portion of the 
second stomach, and are there mixed with the chyme, and cause it to 
separate into a delicate, white fluid, called chijle^ and a residuum, 
which, being worthless, is pushed onward, and thrown out of the 
body. 

Rile in the Stomncli. — Most persons suppose that bile is generally 

found in the stomach ; but this is a mistake. It is thrown up by 
vomiting, because in that act, the action both of the first and the 
second stomach is reversed^ and the bile is forced up from the duode- 
num, — taking a direction the opposite of its usual course. 

Destination of the Chyle. — The chyle being separated from the 
dregs, is pushed onward in its course 
by the worm-like motion of the in- fig. 6i. 

testine ; and as it passes along, it is 
gradually sucked up by thousands 
of very small vessels, whose mouths 
open upon the inner surface of the 
bowel. These little vessels are called 
lacteals, from the Latin word lac, 
which means milk, because they 
drink this white, milky fluid. Fig- 
ure 01 shows a section of the small 
bowel, turned inside out, and covered 
with the villi, or root-like filaments, 
closely set upon its surface, for ab- 
sorbing the chyle, and at the bottom 
of which, the lacteals take their rise. 

In these lacteals, and in the mesenteric glands, the chyle is gradu- 




HYGIENE. 



65 



ally changed, so as to approach nearer and nearer to the nature 
Fig. 62. ^^ ^^^t^' blood ; but precisely what the 

change is, or how it is ctFected, is not 
known. Several men have published 
their theories upon these points, and 
the writer has opinions upon them ; 
but it is not worth while to trouble 
the reader with them. It is sufficient 
to say that the fluid is carried by the 
lacteals to the thoracic duct, through 
Avhich it is conveyed into a large vein 
at the lower part of the neck, where it 
is poured into the blood, and becomes, 
after going through the lungs and ex- 
periencing another and a vital change, 
the material out of which our bodies 
are daily and hourly new-created. 

Figure 62 gives a general idea of 
the stomach, bowels, etc. : 9, being the 
stomach; 10, 10, the liver; 1, the gall 
bladder ; 2, the duct which conveys the 
bile to 4, which is the duodenum ; 3, is 
the pancreas ; 5, the oesophagus ; A, 
the duodenum ; B, the bowels ; C, the 
junction of the small intestines with 
tne colon ; D, the appendix vermifor- 
mis ; E, the coecum; F, the ascending 
colon ; G, the transverse colon ; H, the 

descending colon ; I, the sigmoid flexure ; J, the rectum. 




Nature and Destination of Food. 

The food which man requires for his support and development is 
of two kinds, the inorganic, and the organic. The first of these em- 
braces certain mineral substances, as common salt, sulphur, phospho- 
rus, iron, and lime, either in combination or separate. 

These are not generally reckoned as aliments, and yet no human 
being can live without them. In their absence, the body decays, dis- 
integrates, and perishes. Common salt is composed of muriatic acid 
and soda. The first is an important ingredient in the gastric juice, 
and the latter promotes the secretion of bile. Sulphur is found in 
several of the tissues, particularly in the muscles. Phosphorus united 
to fatty matter, is highly honored in forming a portion of the brain 
and nerves, and is also combined with oxygen and lime to make the 
earthy or hard part of bones. 

Foimd ill Food. — - These articles it is not necessary often to intro- 
duce into the system in a separate state. They are contained, in 
larger or smaller proportions, in most articles of food ; and man always 
sutlers, as all animals do, from their absence. Common salt is found 

9 



66 HYGIENE. 



in the flesh of animal:^, in milk, and in cgg^. It is not very abundant 
in plants ; and we all know how eagerly domestic animals devour it 
when it is given to them, and how constantly wild cattle resort to the 
salt springs, which, in the great West, are called '' buffalo licks." 
Lime exists in nearly all animal and vegetable substances. In wheat 
flour we get it in combination with phosphoric acid, that is, as phos- 
phate of lime. Lime exists, too, in the state of carbonate and sul- 
phate, in all hard water. Iron is found in the yolk of eggs, in milk, 
in animal flesh, in potatoes, pears, cabbages, mustard, and other arti- 
cles. Sulphur we get in flesh, eggs, and milk ; and, as sulphate of 
lime, in spring and river water. Phosphorus is derived from eggs and 
milk ; and flesh, bread, fruits, and husks of grain, commonly called 
bran, contain even a larger proportion than we need in our diet. 

Oi'o'aiiic Food. — The organic elements of man's food, which in bulk 
embrace almost the whole of it, remain to be considered. In the 
animal economy they serve two great purposes. A part of the arti- 
cles which compose them are blood-formers, out of which all the 
tissues are made, — the other part produce fat, which serves to warm 
the body by being burned with oxygen. These articles are derived 
partly from the vegetable and partly from the animal kingdom. 

Dhided into Four Groups. — For convenience, these articles may 
be divided into four groups. For the first, 
sugar stands as a type. We therefore call 
it the saccharine group. It embraces starch, 
gum, and the fibre of wood. These arti- 
cles may all be converted into sugar by a 
simple chemical process. Figure 63 gives a 
microscopic view of the granules of starch. 

The second <Jcroi(p we call the oleaginous. 
It is composed of oily substances, from 
whatever source derived, whether the ani- 
mal or the vegetable world. 

The third group is the aWinninous. A 
good type of it is the white of egg. 

The fourth is the gelatinous, or jell?/ group. 

First and Second Gronps, Snppoi*ters of Respiration. — The articles 
composing the first and second groups are analogous in composition, 
all containing oxygen, hydrogen, and carbon. They are what Liebig 
calls supporters of respiration ; the meaning of which is, in more 
comprehensible terms, that they are supporters of combustion. They 
are the fuel ichich icarms us. They keep the fires going, from which 
arises all the heat we have in our bodies. But they are destitute of 
nitrogen, and, on this account, the}- are not blood-formers, and cannot 
be worked into flesh. Hence, man cannot live on them. 

The food articles embraced in the third and fourth groups, also 
contain oxygen, hydrogen, and carbon : and to these they add nitro- 
gen. This fourth component part, which forms only a small portion 
of them, gives tlicm, for some reason never explained, the peculiar 




HYGIENE. 67 



quality of producing blood and flesh. They are the raw materials, 
out of which our bodies are reconstructed from day to day. 

Feed a man ever so largely upon sugar, starch, gum, and oils, and 
he will starve as certainly as if he were allowed nothing but water. 

\jiiiies of 1H\o Orciit Divisions of Food. — The possession or non- 
possession of nitrogen, then, is what distinguishes from each other 
the t\vo great classes of food-articles. Those which contain nitrogen 
have been called nitrogenized^ and th^se which are destitute of it, 
non-jiifrog-enized compounds. As nitrogen is often called azote, the 
former class are more frequently named azotized ; the latter, non~ 
azoiized. 

Let the reader now fix it in his mind that the azotized articles of 
food produce blood and flesh ; the non-azotized, heat ; and he will 
have the key to understand much of what is to be said, and likewise 
to unlock many of the mysteries of diet. 

\utritioii Table. — Taking human milk as the standard, and ex- 
pressing the amount of nitrogen it contains by 100, the following 
table shows the relative amount of nitrogen in the principal flesh- 
producing articles of food, and consequently their power of forming 
the tissues : 

VEGETABLE. 

Rice, 81 Potatoes, 84 

Rve, - - - - - - 106 Turnips, 106 

Corn, 125 Carrots, 150 

Barley, 125 Peas, 239 

Oats,' 138 Beans, 320 

AVheat, 144 

ANIMAL. 

Human Milk, - - - - 100 White of Egg, - - - - 845 

Cows' Milk, - - - - 237 Herring, 910 

Ovster, 305 Haddock, 816 

Yolk of Eggs, - - - - 305 Pigeon, 756 

Cheese, - . . . 331-447 Lamb, 833 

Eel, 428 Mutton, 852 

Pork-Ham, 807 Yeal, 911 

Salmon, 610 Beef, 942 

Other Standards of Value. — We must not infer that those articles 
which have most nitrogen are necessarily best adapted for human 
diet because they are the most effective blood-producers. In deciding 
the value of an article for food, other things are to be looked at be- 
side its nutritive qualities. Those which are poor in nitrogen, are 
rich in carbon and hydrogen, and are well fitted to serve the double 
purpose of nourishing and warming the body at the same time. The 
fitness of an article for diet, depends very much upon the ease or 
difficulty with which it is digested and assimilated. If an article, 
having a great deal of nitrogen, and being very nutritive, is with 
great difficulty reduced in the stomach by the digestive process, it 



68 HYGIENE. 



may be much less desirable for food than one which is digested and 
assimilated easily, but is much poorer in nutritive qualities. 

Hejit-o'eiieratiiio; Fooil Articles. — The reader has before him the 
principal blood and tissue-forming food articles. Those which we 
reckon as fuel, or heat-generators, are chiefly oils, sugar, starch, farina, 
sago, arrow-root, tapioca, gums, etc. These are less essential than the 
others ; for the blood-forming articles have within them the elements, 
out of which fat is formed in the process of assimilation; for many 
of them contain starch ; and this, in the human organism, is changed 
into fat. The amount of starch in some of these articles is as fol- 
lows : 

"WTieat flour, aood quality, 100, contains 65 to S6 parts in 100 jmre starch. 

AVheat, -' - - 108 " 

Barley meal, - - 119 

BarleV, - - - 130 

Rye,' - - - 111 

Buckwheat, - - - 108 

Indian Corn, - - 138 " 

1 Bice, - - - - 171 " 

! Peas, ... 69 " 



53 


(« 


56 


64 


u 


65 


37 


(( 


37 


44 


u 


47 


43 


(( 


44 


65 


u 


66 


85 


(( 


86 


38 


u 


39 


37 


ii 


38 



White Beans, - - 59 " 

111 the \utritive Food Articles, there is a fixed relation existing be- 
tween the elements of the tissue-formers and the heat-producers, 
which they contain. Out of a few of them Baron Liebig has con- 
structed the following table : 

For eyery ten parts of blood and tissue-formers there are, — 



In Wheat flour, 


10 


46 


In Barley, 10 


. 


57 


In Rye meal, 


10 - 


- 57 


In Rice, 10 - 


- 


- 123 


In Oatmeal, 


10 


50 


In AVhite potatoes, 10 


. 


86 


In Buckwheat, 


10 - 


- 130 


In Blue potatoes, 10 - 


- 


- 130 



Diet a Complex Subject. — From the facts and tables now presented, 
it appears that the question of diet is one of complexity ; and that 
the determination of its several points, require that a number of things 
should be taken into the account. First, in deciding the usefulness 
of any article, we may inquire respecting 

Its Dio'estibilitj'. — If an article be not digestible, it is of little con- 
sequence how much or how little albumen, starch, or nitrogen it may 
contain. The first and most important inquiry respecting it is, is it 
digestible ? If not, it is to be rejected ; for, whatever other qualities 
it may have, it can only injure the stomach, and embarrass the whole 
system. 

The following table will be useful to the reader, though I do not 
set it down as reliable in all cases. There is often a great difference 
in the ease with which different stomachs will digest the same food. 
Many stomachs are alHicted with what is called an idiosyncrasy, — a 
habit, peculiar to itself, of rejecting, or refusing to digest, some one, 
or more, articles which are acceptable to all other stomachs. This 



HYGIENE. 



69 



table shows the length of time required for digesting the several arti- 
cles in the stomach of St. Martin, as shown by the experiments of 
Dr. Beaumont : 



Articles. 



Preparations 



Rice |Boiled . . . 

Fiji's feet, soused . . . .Boiled . . . 

Tripe, soused {Boiled . . . 

Trout, salmon, fresh. .'Boiled . . . 
" '• " jFried. . . . 

Apples, sweet, mellow jRaw 

Venison, steak 'Broiled. . . 

Sago iBoiled . . . 

Apples, sour, mellow [Raw 

Cabbage, with vinegar Raw 

Codfish, ctired, dry. . .iBoiled . . . 

Eggs, fresh Raw 

Liver, beet's fresh. . . .Broiled. . . 

Milk JBoiled . . . 

Tapioca :Boiled . . . 

Milk |Raw 

Turkev, wild : Roasted . . 

" JBoiled . . . 

" domesticated Roasted . . 

Potatoes, Irish Baked . . . 

Parsnips Boiled . . . 

Picj, suckinir Roasted . . 

Meat hashed with | ^y^.^^j, _ 

vegetables ) 

Lamb, fresh Broiled. . . 

Goose Roasted . . 

Cake, sponge Baked . . . 

Cabbage-head Raw 

Beans, pod Boiled . . . 

Custard Baked . . . 

Chicken, full-grown . . Fricasseed 

Apples, sour, hard . . . Raw 

Oysters, fresh Raw 

Bass, striped, fresh . . . Broiled. . . 
Beef, fresh, lean, rare Roasted . . 

" steak Broiled. . . 

Corn cake Baked . . . 

Dumpling, apple jBoiled . , . 

Egirs, fresh Boiled soft 

Mutton, fresh Broiled. . . 

" Boiled . . . 



Time. 



li. m. 
1 — 
1 — 
1 — 
1 30 
1 30 
1 30 
1 35 

1 45 

2 — 
2 — 
2 — 
2 — 

2 

2 — 



15 
18 
25 
30 
30 
2 30 
2 30 

2 30 



Articles. 



Preparations. 



Pork, recently salted 

Soup, chicken 

Oysters, fresh 

Pork, recently salted 

Pork steak 

Corn bread I 

Mutton, fresh j 

Carrot, orange ! 

Sausage, fresh 

Beef, fresh, lean, dry 
Bread wheat, fresh. . . 

Butter 

Cheese, old, strong . . . 
Eggs, fresh 



Flounder, fresh. . . . 

Oysters, fresh 

Potatoes, Irish .... 

Soup, mutton 

" oyster 

Turnip, flat 

Beets 

Corn, green, and beans 
Beef, fresh, lean . . . 
Fowls, domestic . . . 



Veal, fresh 

Soup, beef, vegeta- 
bles, and bread . . 
Salmon, salted .... 

Heart, animal 

Beef, old, hard, salted 
Pork, recently salted 
Cabbage, with vinegar 

Ducks, wild 

Pork, recently salted 

Suet, mutton 

Veal, fresh 

Pork, fat and lean . . . 
Suet, beef, fresh . . 
Tendon 



Raw. . . . 
Boiled . . 
Roasted . 
Broiled. . 
Broiled. . 
Baked . . 
Roasted . 
Boiled . . 
Broiled. . 
Roasted , 
Baked . . 
Melted . . 
Raw. . . . 
Hard boiled 
Fried . . . 
Fried . . . 
Stewed. . 
Boiled . . 
Boiled . . 
Boiled . . 
Boiled . . 
Boiled . . 
Boiled . . 
Fried . . . 
Boiled . . 
Roasted . 
Broiled. . 

Boiled . . 

Boiled . . 
Fried . . . 
Boiled . . 
Fried . . . 
Boiled . . 
Roasted . 
Boiled . . 
Boiled . . 
Fried . . . 
Roasted . 
Boiled . . 
Boiled , . 



Time. 



h. m. 

3 — 



This table may be considered as giving a general idea of the rela- 
tive digestibility of the food-articles contained in it. If not found 
exactly right in each individual case, it can ffe rectified by experience. 
The experience of no other individual's stomach will ever be found 
precisely like that of St. Martin's, — though in its general features, it 
may be sufficiently similar to make his valuable. The general prin- 
ciples of conduct may be learned from the experience of others. The 
particular application must come from our own experience and reason. 

Digestibility Influenced by Amount. — The rapidity with which any 



70 • HYGIENE. 



article is digested will vary with the amount taken. A larger quan- 
tity than is called for by the wants of the system, will be digested 
more slowly than the proper amount ; while, on the other hand, an 
insufficient supply begets an inability to reduce in the stomach even 
the small quantity taken. We may err in taking too little food as 
well as in taking too much ; though the former error is much less 
likely to occur than the latter. 

Choosing Food in 111 Health. — But in deciding the kind and 
amount of food, we must be guided not only by its digestibility, but 
by the state of the health. 

If we find the stomach apparently in good working condition, capa- 
ble of dissolving properly whatever is submitted to its action, and 
yet we are for some cause losing flesh and strength, we should resort 
not only to the most nutritious of the albuminous group of the azo- 
tized articles, but likewise to the oleaginous group of the non-azotized. 
We want a great amount of nutriment, and we need oils to make fat. 
This is the kind of food generally wanted in constitutional consump- 
tion. 

In fevers, but little food can be disposed of at best ; and that little 
must be chosen with reference to its mildness and its unstimulating 
qualities. Generally the farinaceous or starchy articles are most suit- 
able, because they have no stimulating and irritating qualities, and 
especially because they furnish fuel to be burned with oxygen, and 
thus take the place of the animal tissues, which are being rapidly 
consumed with this devouring element. In fever, oxygen is literally 
burning up the body. In this state of the system, this element ac- 
quires, by some means, a singular affinity for the tissues ; and, uniting 
with them rapidly, forms a true combustion. The physician who 
throws to this devouring agent some of the mild, non-azotized articles 
which ofter it stronger affinities than it ffiids in the tissues, is as wise 
as he who tosses his dog to a hungry lion to avoid being devoured 
himself. 

Exercise to be Considered. — In deciding the diet, the amount of 
exercise is not less important to be considered than the health. The 
farmer, who works in the open air, and uses his muscles a great deal, 
wants considerably more nutritive, as well as more combustive, food 
than one who leads a sedentary life. Of course there is a great deal 
more waste of the tissues, and he requires more of the flesh-forming 
articles ; and as he breathes deeper, and takes in more oxygen, he 
needs more of the supporters of respiration, — the sugars, oils, and 
starchy aliments. 

Beans. — By turning to the table which shows the amount of nitro- 
gen in the different food-articles, the reader will see that beans are 
rich in this element. They are, therefore, excellent food for working 
men, who are obliged to make great use of their muscles. Our 
fathers, who broke and subdued the rocky soil of New England, 
showed wisdom even in their instincts in taking so large a portion of 
their aliment from the bean, — especially as they oiled it with the fat 



HYGIENE. 71 



of pork. But for the hard-working student^ who daily makes heavy 
drafts upon his brain and nervous system, beans and peas are an im- 
proper diet. They contain no p'hosphonis, in the shape of phosphate 
of lime ; and no brain can work hard without a due supply of phos- 
phorus, which forms a part of its substance. 

ruboltecl Wheat Flom*. — For the man who uses his brain a great 
deal, there is no other o}ie article of food equal to bread made from 
unbolted wheat flour. Fine wheat flour is little better for him than 
beans, because the miller has robbed it of much of the phosphorus, 
which is found chiefly in the hull or bran. 

I mention only two or three articles of food as specimens. By 
looking over the tables furnished, and reasoning upon the whole in 
the way I have done upon these few, the reader can give every article 
something like its proper value in most circumstances. 

Climate. — If health and exercise should influence us in choosing 
the kind and the amount of food, climate must do so quite as much. 

In the frigid climate of high latitudes, it is necessary that a great 
deal of heat be produced in the body, in order to avoid perishing with 
cold. There is no mystery now, as there once was, about the produc- 
tion of this heat. It comes from the burning of carbon and other sub- 
stances in the body, where they unite with oxygen, and make just as 
real a fire as that which warms our houses. Oils, sugar, starch, gums, 
etc., are largely composed of carbon, and readily unite with oxygen 
in the body. This is the reason why they are reckoned as fuel, and 
are called supporters of combustion. And /or this reason, they require to 
be largely consumed in very cold climates. The instincts of men seem 
to lead to the same conclusion, for the dwellers in all high latitudes, 
consume great quantities of oils and fats. The amount of train oil, 
tallow, the fat of seals and other animals, devoured by the Laplanders, 
Kamtschatkians, and other northern people, is truly wonderful. 

In hot countries, the fundamental rule for preserving the health, is 
to keep the body cool. Without observing this rule, the strongest will 
often fall victims to the climate in low latitudes. ' But to keep cool, 
of course all the heat-producing articles of food should be avoided. 
Particularly all alcoholic drinks, which are powerful supporters of 
combustion, should be rejected. Rice, and the various fruits form the 
most suitable articles of diet. 

The great sacrifice of life which we have witnessed the last few 
years among the emigrants to California, has been the result chiefly 
of using ardent spirits and heat-producing food while crossing the 
Isthmus, which, to a northern constitution, is much like a vast oven, 
heated to a temperature suitable for baking bread. There are few 
persons, with tolerable health and strength, but would safely endure 
the ordeal of the Isthmian passage, if they would live light for a few 
days before starting ; and during the passage, take only an abstemious 
vegetable and fruit diet. 

Bayard Taylor's Opinion. — The distinguished traveller, Bayard 
Taylor, reports that while spending a few days in a heated part of 



72 HYGIENE. 



Africa, he lived, as the inhabitants did, pretty much entirely upon the 
flesh of well-fatted sheep ; and that he enjoyed, meantime, excellent 
health and strength. From this he concludes that animal food is as 
suitable in hot climates as in cold. 

It is a pity a man of such excellent parts as Mr. Taylor, should 
allow himself to rear so tall a structure upon so narrow a foundation. 
That he could live on flesh in so hot a region, and not be made sick, 
only proves that he has a fine constitution, and that his health is not 
easily disturbed ; and when he attempts from his limited experience 
of a few days, to reason against the established facts of science, and 
against the well-attested laws of life, he does it evidently without 
reflecting that he is in a field of thought which he has never had oc- 
casion to cultivate. 

The great Jewish Lawgiver doubtless had a reason for prohibiting 
pork to the Jews. Whatever that reason was, the prohibition had a 
wise bearing upon the health of the people. Palestine has a hot 
climate, in which pork-fat is an improper diet. 

More Flit in Winter. — It follows from what has been said, that a 
more fatty as well as stimulating diet is needed in winter than in 
summer. But the change should be made gradually. When cold 
weather approaches, the food should become more nutritious and 
warming by little and little. The exercise should likewise be in- 
creased. 

Even the lower animals act upon this plan. In the fall, squirrels 
eat nuts, which are fall of oil, and grow fat upon them. 

The instincts of men move in the same direction. It is in the fall 
that the hog, the ox, and the poultry are killed ; and in the winter 
that they are largely feasted upon and enjoyed. Upon such food, 
combined with various sorts of starch, man fattens ; and a good sup- 
ply of fat, deposited in the cells, is equal, in keeping out cold, to a 
layer of cotton batting, — to say nothing of the fire kept up within 
the body by the burning of such fuel. As hot weather comes on, we 
gradually lay aside these fattening articles (or ought, to), and return to 
the watery vegetables and fruits, such as squash, string beans, straw- 
berries, currants, etc. 

Few of Us, I apprehend, would suffer from heat in summer, if we 
could persuade ourselves to abandon stimulating and fire-producing 
food, and confine ourselves pretty much to a cooling and succulent 
diet. Diarrhoeas in summer are not induced by eating wholesome 
vegetables, but by combining them with large quantities of animal 
food. 

The Stsite of the Mind. — This should by no means be overlooked 
in choosing the kind and the amount of food. If we have lost 
friends, or heard desponding news, or experienced calamities of any 
kind, we must during the first hours of the shock, or even during the 
first days, if the affliction be heavy, partake very sparingly of food. 
The stomach is in no condition to receive it The brain lies prostrate 
under the stroke, and the stomach, in sympathy with it, asks for a day 
of sorrow and fasting. Disturb it not. 



HYGIENE. 73 



Ileat-prodnciiio; Food Incoiiipatible with Excitement. — It is folly 
to take heat-producing aliment when laboring for days under high 
excitements. During political campaigns, wlien the blood of poli- 
ticians is at the boiling point, the diet should be unstimulating, — 
containing very little animal flesh, and not much combustive food. 
Many a man has died of apoplexy, or of heart disease, by putting on 
the steam when his blood was up. Whenever we have a day of un- 
common excitement to pass through, we should always begin and 
end it with an unusual degree of abstinence as to the amount of 
food taken, and with special care that the articles be of the lightest 
kind. 

Ang'er Demands Abstinence. — Anger is a passion which especially 
unfits the stomach for doing much work. If it occur often, or be 
protracted, but little food should be taken. Those who indulge it, 
have a double caui^e for abstinence. Both their folly and their stom- 
achs call for a fast. 

Food Adapted to Different Periods of Life. — Food must vary in 
different periods of life. The infant needs a fattening diet ; and this 
has been supplied in the milk of the mother, which contains more 
butter (the fattening portion) than the milk of any other animal. But 
as the infant has much less exercise than the young of animals, its flesh 
is not wasted, and it does not require so much azotized food, that is, 
the reader will remember, food with nitrogen in it. Accordingly, it 
will be seen by looking at the table on page 67, that human milk has 
much less of this element than that of the cow. As the child grows 
up, and begins to take active exercise, indoors and out, it wants more 
solid food, and teeth make their appearance to masticate or chew it. 

In Yontli and Manhood, the great amount of exercise usually taken, 
calls for larger supplies of azotized aliment, — beef, mutton, pork, 
fowl, fish, w^heat fiour, corn-meal, rye-meal, potatoes, turnips, peas, 
beans, etc. This is the working part of life, when the tissues are 
rapidly wasted by action, and the flesh-forming alime?its are wanted 
to keep them good. 

In Old Ag'e, the exercise is diminished, the blood circulates more 
slowly, and the body grows cold. Now is the time to resort to non- 
azotized food, — oils, fats, the various kinds of starch, sugar, and the 
like. These will furnish fuel to warm the sluggish blood, and will 
invest the body with fat, which will serve the purpose both of a cush- 
ion and a garment. Wine, beer, porter, and distilled spirits are never 
needed by young persons in health ; but the aged are frequently bene- 
fited by them, if taken in small quantities. They are chiefly com- 
posed of oxygen, hydrogen and carbon, and are properly ranked with 
the supporters of combustion. They are likewise stimulant, and add 
to the comfort of the old by quickening their circulation. Like tea 
and coffee, they diminish the waste of the body, and thereby lessen 
the demand for food. 

The smallest amount of aliment upon which a healthy adult person 
ever lived for any length of time, was twelve ounces a day. Upon 

10 



74 



HYGIENE. 



this small daily allowance, Lewis Cornaro, a noble Venetian, sub- 
sisted in perfect health, during the protracted period of fifty-eight 
years. This he was able to do only by adding daily to his food 
about twelve ounces of light wines. I shall have occasion to refer to 



this case again. 



Cost of Food. 



0\E other consideration must ever influence the great majority of 
men in selecting their food. I mean its cost. It is a matter of great 
importance to the poor, to know what kinds of food they can subsist 
upon with least expense. For the last few years provisions have been 
so high, that persons in poor circumstances greatly need advice in 
this matter. Let me endeavor to furnish some information which 
shall be of service to the reader. 

Milk is supplied by nature to be our first food, and is a good type 
of all alimentary substances. It contains fig. 64. 

curd^ which has nitrogen, and is equivalent 
to albumen and fibrine, and represents the 
blood-formers. It has butter and sugar. 
These represent the heat-formers. It has 
salts, which contain potash, soda, phospho- 
rus, etc. Figure 64 is a microscopic view 
of good milk ; Figure Q>o^ of poor milk ; and 
Figure 66, of milk adulterated with calf's 
brains. 

Food will be valuable in proportion as 
it combines, in due proportion, the articles 
contained in the four groups, represented by albumen^ fat^ sugar, and 
salts. 

Fig. 65. 






Albuminous Group. — Albumen, fibrine, casein, gluten, and lugu- 
min, all enter into the substance of animal and vegetable bodies, and 
are all composed of the same elements, namely, 48 parts carbon ; 36 
of hydrogen ; 14 of oxygen ; and 6 of nitrogen. In containing nitro- 
gen they all differ from the other three groups. Albumen being a 
good type of them, they are called albuminous compounds. Albu- 



HYGIENE. 75 



men forms a large portion of the serum, or colorless part of the blood. 
It is the leading principle in alimentation. It is worked up into the 
tissues of our bodies. It forms our muscles, our membranes, a por- 
tion of our nerves, etc. It is the bricks of which the house we live 
in is made. All the articles, therefore, which are chemically consti- 
tuted like it, may well be termed albuminous. 

These bodies, consisting of the four organic elements named above, 
have been called quaternary compounds. Beside these elements, they 
have a minute portion of sulphur and phosphorus. It has been as- 
sumed that these compounds contain a common principle called pro- 
teine ; and hence they have been called proteinaceous compounds. It 
is doubtful whether such a principle can be obtained. 

Albumen is a very unstable compound, — tending strongly to de- 
composition. This is owing to the complexity of its composition, 
and to -its union with the fickle element, nitrogen, which forms chemi- 
cal compacts reluctantly, and breaks them without remorse. Sub- 
stances which coagulate or fix albumen in an insoluble compound, 
or preserve the tissues of the body, which are made from it, from 
decomposition or putrefaction, are called antiseptics. 

Fatty (*roup. — The next group, represented by fat, performs very 
important oilices in the system, — the most important of which, is a 
union with albumen in the formation of cells. All animal and vege- 
table life begins with the cell, — the tiny cup, with which nature dips 
all the streams of life out of the great fountain of inorganic matter. 
No cell is formed without a minute particle of oil. The portion not 
used in forming cells, is either burned as fuel, to keep us warm, by 
uniting with oxygen, or it is stored away in the cellular tissues, adding 
to the bulk of the person. If, then, the very beginnings of life are 
dependent upon fat, it is of great importance as an article of diet. So 
necessary is it in the economy of life, that when not taken in the 
food, it is formed out of albumen in the processes of assimilation. 

Tlie Stiirch and Sii^'ar CJroup, composed of several kinds of sugar, 
gum, etc., is never used in forming the tissues, but they perform im- 
portant offices in the changes going on within the human organism. 
Thus, sugar of milk is decomposed, and forms lactic acid, so called 
from being found in sour milk. This acid plays a very important 
part in the process of nutrition. 

Pure starch is a snow-white powder, having a glistening aspect. It 
is composed of grains from ^l^ to g^Vu of an inch in diameter in the 
different grains ; being largest in the potato, and smallest in wheat. 
When examined with the microscope, they appear as in Figure 63. 

The Salts (iroiip are sufficiently spoken of in another place. 

A wise philosopher in ancient time said, " I do not live to eat and 
drink ; I eat and drink to live." If we intend to eat to live, we must 
combine, in our food, the four groups above explained ; and if we 
would live at as small expense as possible, we must take those articles 
which are low in price, and rich in nutritive matter. The following 
table will help the reader make his selections: 



76 



HYGIENE. 



Table of the relative value of articles of food arranged according to 
nutrient matter in each of the four groups of elements concerned 



their proportions of 
in vital changes. 



In 100 pounds of 



Grains. 

Wheat 

Barley 

Oats 

R}-e 

Indian Corn 

Buckwheat 

Rice 

Pod Plants. 

Beans 

Peas 

Roots. 

Potato 

Turnip 

Carrot 

Beet (mangold wurtzel). 

Long red 

Short red 

Susar beet 

Parsnip 

Leaf. 

Cabbase 



Meal. 

Wheat flour 



Rye meal 



Barley meal 
Oat meal. . . 



1^ 
II 



15 
15 
16 
12 
14 
15 
13 

14 
14 

75 

88 
85 
85 
85 
85 
85 
80 



10.33 



•-I 



15 

15 

20 

10 to 20 

6 
25 

3 

8 to 11 
9 

4 

2 

3 

2 
3.03 
3.31 

2 



14.50 4.63 



Wheat bran I 13.1 



55 



3 O y. 

Hi 



10 to 19 
12 to 15 
14 to 19 
10 to 15 
12 



24 to 28 
24 

2.0 

1.5 

1.5 

2 

0.48 

0.26 

2.5 

30 to 35 

9.70 

8.97 

14 
18 
19.3 






2 to 4 

2 to 3 
5 to 7 

3 to 4 
5 to 9 

0.4 
0.7 

2 to 3 
2.1 

0.3 
0.3 
0.4 



0.35 






55 
60 
60 
60 
70 
50 
75 

40 
50 

18 

9 

10 

11 

10.36 
12.46 
13 
16 



68 Starch 
5.85 Sugar 
4.12 Gum 
66.54 Stch 
56 SuGjar 
40 Glim 
68 
62 
.6 



r66. 

^|2.5 
( 9.4 



O tn 



4 
2 

4 
Oh 

3 
3 

I to It 
i to 4-5 
li to 2 
I to 1 
H 



2 

2 
7.3 



'I'he following tables have an admirably practical bearing 
economy in food : 



upon 



100 lbs. 



Barley, 

Beans, 

Beets, 

Buckwheat, . . . 

Carrots, 

Corn, 

Oats, 

Peas, 

Potatoes, 

Turnips (field). 
Do. (Swedish), . 
Wheat Flour, . 
AVheat Bran, . . 

Cheese,* 

Cheese,t 



Muscle-forming 

Elements, 

iu lbs. 



Fat-forming 

Elements, 

in lbs. 



Relative Propor- 
tion of each, 
in lbs. 



Whole milk. 



14 
26 

2 

8 

12 

17 

24 

2 

li 
2i 
11 

18 
28 
45 



t Skim-milk.' 



64 
42 
12 
54 
10 
77 
66 
52 
19 

9 
12 
79 

6 
27 

6 



1 to 4h 
1 to ll 
1 to 6 
1 to 6| 
1 to 6| 
1 to 6i 
1 to 4 
1 to 2\ 
1 to dh 
1 to 6 
1 to 5h 
1 to 7 
1 to J 
1 to 1 
1 to i 



Husky, or 

Woody fibre, 

in lbs. 



15 

10 

CO 

25 
3 
6 

20 
8 
4 
2 
2 

55 



HYGIENE. 



77 



Articles. 



Barley, , bl 

Beans, 

Corn, 

Oats, 

Peas 

Potatoes, 

Turnips 

Flour (fine) 

Flour (unbolted), 



50 per 

50 '< 



bu. 



1 10 " 
68 " 

2 00 « 
1 50 " 

50 " 
12 OOperbbl. 

11 00 « 



Muscle-producing 
Elements. 



8.4 lbs. 

16.6 " 

6.7 " 

5.2 " 

14.3 " 

1.6 " 

1.2 " 

22.0 " 

2-4.8 " 



Cost of Muscle-produc- 
ing Elements. 



18c. per lb. 

15c. " 

16ic. " 

13c. " 

14c. " 

94c. " 

41c. " 

54c. " 

44c. " 



These tables will well repay study, for their practical use will save 
many dollars to the poor. Let it be remembered that producing 
muscle is the same thing as producing strength, or labor power. 
Bearing this in mind, the following table will be very interesting: 

One pound of labor-power from Potatoes costs 94c. per lb. 
" " '' '' " Fine Flour, 54c. " 





u 


i( 


Uunbolted do. 44c. 




u 


(( 


Turnips, 41c. 




(( 


u 


Barley, 18c. 




a 


u 


Corn, 1 7c. 




u 


u 


Beans, 15c. 




a 


u 


Peas, 14c. 




u 


u 


Oats, 13c. 



Meats are omitted in the table. So far as their nutritive qualities 
are concerned, it is of little consequence which are taken. Some are 
more digestible than others, and this consideration should influence 
those with weak stomachs in selecting. Every person, of course, 
knows their relative cheapness. 

Among the vegetables given in the table, there is a wider range for 
choice. Let us consider them in course. 

Wheat. — In this, the four groups are represented in excellent pro- 
portion. When not deprived of the bran, it is perhaps the very best 
supporter of animal life. So high have been the regards of men for 
it, and so generously have they awarded to it their acknowledgments, 
that its product, bread, has been everywhere called " the staff of life." 
It is unfortunately held at a high price. My hope is that the immense 
prairies at the West, adapted to its culture, will yet furnish it in such 
profusion as to bring it within the means of all. 

Barlej'. — This has the four groups represented in nearly the same 
proportions as wheat. It is, therefore, nearly as valuable an alimen- 
tary grain. Unfortunately it is not so toothsome as wheat, and can 
never be so popular an article of diet. The Scotch, however, feed 
upon it with apparent relish, and doubtless think it strange that for- 
eign palates are not better pleased with it. 

Oats. — This grain, strange to say, has more albuminous, or nutri- 
tive matter, more fat, more starch, and more salts than wheat. In 
uniting a large quantity of the four alimentary groups, it surpasses 
every other vegetable substance. In albumen, it is not quite as rich 



HYGIENE. 



as peas and beans, and in starch it falls a trifle below fine wheat 
flour ; but in fat it is exceeded only by Indian corn. This grain is 
likewise consumed largely by the Scotch, — a people whose claims to 
shrewd common sense are well supported by, as their hardy consti- 
tutions vindicate, the choice. This grain might well be permitted to 
take the place of rice. It affords several times as much nutriment, 
while it costs only about one-fifth as much. There is good reason 
why the horse should thrive upon oats. Most stable-keepers think 
their horses will do more work upon corn-meal, but this must be a 
mistake. In using oats for horse-feeding, a large portion of the nu- 
triment is lost by not grinding them. 

Rye. — This is also a grain of considerable nutritive value. It is 
much cheaper than wheat ; and rye meal has long been a standard 
article of diet in New England, — particularly in connection with 
Indian meal, as " brown bread." It is useful for relieving costiveness, 
in the form of " hasty-pudding," with molasses. 

Indian Corn. — This staple article of American produce needs no 
praise from me. It is comparatively cheap, nutritive, and wholesome. 
It abounds in fat and starch, and has a fair amount of albumen, 
though not as much as the oat, the barley, or the wheat. In salts, it 
is rather deficient. Indian corn is strictly an American plant, and is 
perhaps the most popular grain in the country. It has emphatically 
a national reputation, and is perhaps worked up into more savory 
dishes than any other. At the South it is an institution. It is there 
made into hoe cake, corn cake, batter cakes, batter bread, muffins, corn 
pone, etc. At the North, we have jonny cake, Indian and pumpkin 
cake, baked Indian pudding, boiled Indian pudding, beside the well- 
known rye and Indian bread, and other preparations. Give an in- 
genious Southern or Northern housewife a few simple adjuncts, such 
as lard, milk, sugar, eggs, cream of tartar, and soda, and she will 
make a pretty respectable larder from this single grain. If molasses 
be substituted for sugar, and a little stewed pumpkin be thrown in 
by way of garniture, we may have several preparations which are 
very nourishing as well as cheap. 

Buckwlieat. — Poor in nutritive matter, fat, starch, and sugar, but 
tolerably well supplied with salts. It will do very well for batter 
cakes in winter. When brought smoking upon the table, and served 
with sugar or molasses and butter, these cakes are a luxury, in which 
the rich may indulge if they choose ; but for the poor, the amount of 
nourishment they afford is too small for their cost. 

Rice. — Much like buckwheat, except that it has more fat, sugai\, 
and starch, and less salts. As an article of diet, it has had too high 
a reputation. Those who would live on small means cannot afford it. 
Boiled in plain water, it is excellent for a relaxed state of the bowels ; 
and this is about all the commendation to which it is entitled. 

Beans. — The richest in nutritive matter of all vegetable substan- 
ces, except cabbage and oats. They have more albumen than wheat. 



HYGIENE. 79 



or corn, or barley, or oats ; but in fat and starch, they are lower in 
the scale. Add to them salt pork, and the highest of all nutrient 
compounds is obtained. Daring not less than four generations, pork 
aiid beans, as the principal diet, nourished an iron-sided race of men 
in New England. Bean-porridge was like honey upon the tongue of 
the founders of New England institutions. They ate it morning, 
noon, and night ; and thanked God for it every time. And well they 
might thank Him ; for, with Indian corn, it furnished them with a 
diet better adapted to their condition than any other. 

Peas. — Not quite as rich as beans in albumen, but more rich in 
starch ; of about the same value on the whole. The Canadian French 
in Lower Canada, feed on peas to about the same extent that the 
New Englanders did on beans. Pea-soup, as prepared by the best 
cooks among them, is a dish of great nutritive excellence ; and, in 
my judgment, more palatable than bean-soup. 

Tlie Potato. — Three-quarters of this root is water, and it is poor 
in all the elements of nutrition. It is a palatable article, and most 
persons are much attached to it. As bulk is of some consequence in 
food, the potato is not without value ; but should the disease with 
which it has been tormented for several years, finally exterminate it, 
the loss to the world would not be so great as many suppose. Men 
do not often live entirely upon potatoes, — not even in Ireland. Milk, 
butter-milk, and especially cabbage, are united w^ith them. 

Turnips, Carrots, Beets, Parsnips. — These are much alike, — being 
all poor in nutritive qualities. They serve to please the palate by 
furnishing a variety ; but in our city markets, they are expensive, and 
do not furnish an economical diet. 

Cal)l)a2;e. — It is interesting to observe how the instincts of men 
have in all ages led them to select those articles of diet which their 
circumstances have demanded. The poverty of the Irish has led 
them to subsist largely upon the potato, — a root w^hich the soil of 
their country yields profusely. But as this root has but little nutritive 
matter, necessity required that it should be united with some other 
vegetable. The natural instinct selected the cabbage ; and when 
chemical science came, at length, to pass judgment upon the correct- 
ness of this instinct, it turns out that the cabbage is the richest in 
albumen of any known vegetable. The cabbage, then, is the natural 
complement of the potato ; and the Irish had the sagacity, without 
science, to bring the two together. It is said the Irish have a dish 
named " kohl-cannon," consisting of boiled and mashed potatoes and 
cabbage, seasoned with pork fat, pepper, and salt, and that it is a 
truly savory dish. It certainly is a nourishing, and a cheap one. The 
ambassador who V\ras sent to tamper with the patriotism of a Roman 
who had dined on beans, was asked if he was silly enough to think 
gold and silver could bribe a man, who was satisfied with so plain a 
fare, and desired no other. We come to the conclusion, then, that 
bean porridge, pea soup, suet pudding, sweetened with molasses, oat 
meal, and barley bread, with " kohl-cannon " for those who can digest 



80 HYGIENE. 



it, will furnish, for hard-working men, the niost substantial diet, at the 
smallest possible expense. To render these dishes savory, and to 
make the table on which they are spread an inviting board, the deft 
housewife must employ her best skill in serving them. With the 
thousand " fixings," with which a New England matron knows how to 
garnish them (or would know how if they came within her culinary 
operations), they are well fitted to leave savory impressions upon 
tongues which would praise them to the end of life. I speak of these 
articles as furnishing a cheap diet for working men. The indolent, 
the sedentary, and the effeminate from various causes, could not 
digest them. 

The Amount of Food Taken. 

We have already explained that this should be governed, in part, 
by the amount of exercise taken, by the condition of the health, by 
the state of the mind, by the climate, by the season, etc. It remains 
to add a few words, in a general way, respecting the absolute amount 
required by an adult man. 

It is plain enough that most men eat too much. We come very 
near, in this country, being a nation of gormands. A principal reason 
of our over-eating is, that we eat so fast. When the food is well and 
slowly masticated and swallowed, the gastric juice has time to mix 
with it ; and at the proper moment, the appetite ceases. But when 
our food is bolted rapidly, nature, finding her laws disregarded, and 
all her purposes frustrated, stands back, and lets us learn to stop, too 
late, alas I from a sense of fulness in a stretched and abused stomach. 

It has already been stated, that Lewis Cornaro lived fifty-eight 
years, namely, from the age of forty-two to one hundred, on twelve 
ounces of solid food a day, with about the same amount of light 
wines. At the age of eighty-four, he wrote a book, in which he 
praises " divine temperance " in terms which are sometimes eloquent, 
and often enthusiastic. Indeed it is very rare that a man at that age 
retains such clearness of intellect, and especially such freshness of 
feeling as he evinces in his book. Probably but few could live on the 
amount of food which he found sufficient. Yet it is said the distin- 
guished John Wesley lived on sixteen ounces a day, which, as he took 
no wine, and had to derive the combustive materials for warming the 
body from the food, was quite as scanty a fare as that of Cornaro. 
Considering that he led a most extraordinarily active life, both of body 
and mind, being half his waking hours in the saddle, and preaching 
almost daily, this is probably the most remarkable case of abstemi- 
ousness on record. Jonathan Edwards did not, I think, exceed the 
same amount of food, but he was not so active a man. 

Putting aside such exceptional cases as these, we may say in round 
numbers, that a laboring man requires, to keep him in health, about 
two to two and a half pounds of solid food per day. For ministers, 
lawyers, doctors, authors, and merchants, one pound and a half is 
amply sufficient. The amount should be increased a little by a se- 
lection from some of the fuel-formers, if no fermented or alcoholic 



HYGIENE. 81 



drinks be taken, and slightly diminished if they are used. The reason 
is, that these drinks furnish fuel to be burned in breathing, which has 
to be drawn from the food, when they are not employed. This fur- 
nishes no motive for using' ardent spirits ; for there is fuel enough to 
be had in the oils, starches, and sugars. 

Dyspeptics. — It is said that dyspeptics eat more than persons in 
health ; and, in many cases, the remark may be true. The appetite 
of a person suflering from this disease is almost always morbid, and 
the information it gives respecting the real wants of the system, can 
seldom be trusted. If we allow a diseased stomach to dictate to us 
when, and what, and how much we shall eat and drink, our misery 
for life is a foregone question. A sick stomach is like a spoiled child; 
it cries for what it should not have. If the dyspeptic will live, and 
enjoy any amount of peace and comfort, he must follow this simple 
rule :. To eat no more than can be digested^ even thovgh the amount be 
only an ounce a daij. 

Animal and Vegetable Food. 

It has generally been supposed that it was intended man should 
subsist on a mixed diet, consisting of both animal and vegetable sub- 
stances. AVithin the last twenty-five years, however, a school of 
physiologists have appeared in this country, who afiirm that a vege- 
table diet is alone consistent with the laws of health. They declare 
that animal food is not adapted to man's organization, — that it un- 
duly stimulates the blood, predisposes to fevers, consumptions, diar- 
rhoeas, choleras, apoplexy, and numerous other diseases, and of course 
shortens life. That such a school should have come into existence in 
this country, where animal food is more largely consumed than in 
any other part of the world, in proportion to the number of people, 
is not surprising. We do, undoubtedly, eat too much flesh. So 
enormous is the consumption, that notwithstanding the vast herds of 
cattle raised in all our agricultural states, the supply is not equal to 
the demand ; and beef, for two years, has been selling in Boston mar- 
ket at twenty cents per pound, — at least twice its fall value as a 
blood-former. 

Facts show that man may live upon flesh alone, upon vegetables 
alone, or upon flesh and vegetables combined. Is it best he should 
subsist upon vegetables only, or upon a mixed diet ? A mere affirm- 
ation upon these points is of little consequence. To cite facts avails 
nothing. Men have a way of making their own affirmations, and of 
looking at facts wdth eyes which sometimes see clearly enough on 
both sides of them, but totally ignore their existence. 

Man's Structure Settles the (Question. — To settle this matter, we 
must appeal to man's organization. His structure will tell us some- 
thing we need not mistake. All the works of God show design. 
Everything he has made has a use, and is so contrived as to be 
adapted to that use. Lions, tigers, and other animals for example, 
which feed on flesh alone, have a short second stomach, — it being 

11 



82 HYGIENE. 



only about three times the length of the animal's body. Animals 
which eat no flesh, have a long second stomach, — that of the sheep 
being from thirty to thirty-five times the length of its body. A very 
remarkable difference of anatomical structure I 

This is the meaning of the difference : Vegetable food has a great 
deal of waste matter in it. Woody fibre makes quite an item in its 
composition. This waste portion must all be carefully separated from 
the nutritive part, and this must all be done in the second stomach. 
It takes time to do it. It must not be done in a hurry. The nutritive 
materials are destined to build a living structure, whose duration, like 
that of all other fabrics, will depend on the care with which the mate- 
rials are selected and put together. The second stomach of the sheep 
is long, that there may be ample time for the mixed mass of chyme 
when it passes out of the first stomach, to be changed to chyle, and 
then to be carefully separated into the two parts, the useful and the 
useless. Animal food is in its composition just like our own flesh, — 
there is little waste matter, and not much time is required for its sep- 
aration ; hence, the second stomach of flesh-eating animals is short. 
Nearly the whole alimentary mass is quickly taken up by the lacteals, 
and there is no occasion for its travelling through a long second 
stomach. 

Mmi's second stomach is in length midway between that of the 
flesh-eating and the vegetable-eating animals. If there be design in 
the works of the Creator, and if that design in the structure of the 
flesh and vegetable-consuming animals has now been correctly inter- 
preted, it is plain that man is best nourished when he eats both kinds 
of food. The structure of his teeth, and the motions of his jaws 
(see p. 30), confirms the same conclusion. 

Americans Eat too Much Meat. — Yet, as I have said, there is no 
doubt the Americans eat too much meat. Sedentary persons require 
but very little. Less is wanted in summer than in winter, — in warm 
climates than in cold. People of wealth, whose circumstances im- 
pose no bodily hardships, need less than the poor, who are much 
exposed, and work hard ; whereas, they consume more. Those who 
do not labor with their hands, should never taste meat more than 
once a day. 

It is painfully-amusing (if such a compound word is admissible) 
to hear a nervous female, whose sole exercise consists in going from 
the parlor to the kitchen once or twice a day, and in making a brief 
shopping excursion once a week, complain that she cannot maintain 
her strength unless she eats freely twice a day of meat, and takes her 
free potations of strong coffee and wine. 

A like opinion prevails generally among the feeble who are not 
obliged to labor. The child in its nurse's arms, must daily, it is 
thought, suck a piece of chicken or beef steak in order to' thrive. 
Children thus fed, have their blood constantly inflamed, and stand a 
poor chance when attacked by scarlet fever. The little master or 
miss wiio attends school, complains of headache, and grows pale, 
feeble, and nervous. The books are blamed and thrown aside for 



HYGIENE. 83 



what the dishes have done. The doctor is called in, and assured that 
the dear child can eat nothing but a little fat broth, a custard, or 
cake ; and if he prescribe a diet of plain bread and milk, he is be- 
lieved to be heartless, and his prescription is not followed. 

Tlie Hiijority of Mankind Eat no Flesh. — All such misguided per- 
sons should be apprized that the great majority of mankind eat no flesh, 
because they cannot afford it. And they do not appear to suffer from 
its loss. Millions of Irish do not taste of flesh or fish from one month's 
end to another. Potatoes, oat meal, and cabbage constitute their chief 
diet. Rice, poor as it is in nourishment, sustains, when combined with 
vegetable oil, millions of people in Asia. The Lazaroni of Naples, 
with active and finely moulded forms, live on bread and potatoes. 
These facts do not aflbrd ground for altogether rejecting animal food, 
any more than Bayard Taylors statement respecting whole tribes in 
Africa who live upon flesh, furnishes a reason for excluding vegetable 
aliment. ^lan may live and enjoy health upon either, but his organ- 
ization implies the use of both. 

Proportions of Animal and Vegetable Food. 

Upon this subject, it is impossible to fix any absolute rules. This 
is a point which must be determined by the temperament, the state 
of the health, the constitution, etc. Persons of a scrofulous habit 
should eat freely of animal food. But an inflamed stomach should 
never be tormented with flesh. Meat is stimulating, and will be al- 
most sure to do mischief when there is heat and tenderness at the pit 
of the stomach. There are cases of inflammation of this organ, in 
which it may be necessary to live on bread and milk, with articles of 
the starch gronp^ for months, and even for years. 

On the other hand, when the system has run low from some ex- 
hausting disease, which excites no feverish action, it may be necessary 
at times, to take a diet almost exclusively animal. 

It is absurd to talk of the same diet as adapted to all persons, even 
when in health. As well might we expect one shoe to fit every foot, 
or one coat every back, or one color every eye, or one doctrine every 
mind. 

Temperance tlie Main Tliino'. — After all, the great thing to be 
aimed at is temperance. It is not so necessary to reject one article 
and use another, as to partake of aU with moderation. " I do not 
live to eat and drink ; I eat and drink to live," said a wise philoso- 
pher of the olden time. One would think the moderns had reversed 
this rule. A modern table has the appearance of being spread for the 
purpose of inducing men to eat all their stomachs will hold. A man 
who can dine daily, for half a dozen years, at one of our first class 
hotels, and then find himself free of dyspepsia, and all other diseases, 
must have a fine constitution, as well as most admirable control over 
his appetite. Mr. Addison said, " When I behold a full table set out 
in aU. its magnificence, I fancy I see gout, cholic, fevers, and lethargies 



84 HYGIENE. 



lying ill ambuscade among the dishes;" to which he adds, with much 
truth, in another place, " Abstinence starves a growing distemper." 

Good Results of Teiiiperniice. — A temperate diet has always been 
attended with excellent results, and always will be. There are times 
of great anxiety, when abstinence should be pushed to the extreme 
verge of endurance. During the siege of Gibraltar, Lord Heath- 
field, its gallant defender, lived eight days on four ounces of rice per 
day. Dr. Franklin, when a journeyman printer, livc^d two weeks on 
bread and water, at the rate of ten pounds of bread a week, and was 
stout and hearty. Dr. Jackson, an eminent physician in the British 
army, says, " I have wandered a good deal about the world, and never 
followed any prescribed rule in anything ; my health has been tried 
in all ways ; and by the aids of temperance and hard work, I have 
worn out two armies, in two wars, and probably could wear out an- 
other before my period of old age arrives." 

Lord Bacon was right in the opinion that intemperance of some 
kind or other destroys the bulk of mankind, and that life may be sus- 
tained by a very scanty portion of nourishment. Cornaro, whom I 
have before mentioned as having lived fifty-eight years on twelve 
ounces of solid food a day, wrote as follows respecting himself in his 
eighty-fifth year: " I now enjoy a vigorous state of body and of mind. 
I mount my horse from the level ground ; I climb steep ascents with 
ease ; and have wrote a comedy full of innocent mirth and raillery. 
When 1 return home, either from private business or from the senate, 
I have eleven grand-children, with whose education, amusement and 
songs, I am greatly delighted ; and I frequently sing with them, for 
my voice is clearer and stronger now, than ever it was in my youth. 
In short, I am in all respects happy, and quite a stranger to the dole- 
ful, morose, dying life of lame, deaf, and blind old age, worn out with 
intemperance." Howard, the philanthropist, fasted one day in the 
week ; and Napoleon, when he felt his system unstrung, suspended his 
meals, and took exercise on horseback. 

Nothing can be plainer than the duty of fasting, when the stomach, 
having been overworked, is disinclined to receive food. Brutes in- 
variably follow this suggestion of nature ; they never eat when sick, 
— probably because they have no silly nurses to coax them to swal- 
low stimulating ahments. The habit of putting high-seasoned food 
into the stomach when it is inflamed and feverish, is about as wise 
as directing streams of blue, violet, or red light into the eye when it is 
red and swollen with inflammation. 

Tea and Coffee. . 

It is proper before closing this chapter upon diet, that something 
should be said respecting the beverages of tea and coffee. 

Some twenty years ago, more or less, a meeting was held by the 
leading physicians of a city in the old world, in which the merits of 
tea and coffee were discussed. In this discussion each man first 
stated his experience in the use of these articles, and then con- 



HYGIENE. 85 



structed his [irgniiient according to that experience. The amount of 
what the reader could learn from the discussion was, that Dr. A. had 
used tea all his hfe, and been benefited by it, while coftee had uni- 
formly injured him ; and that he thought tea should be used, while 
cotiee should be rejected ; — that Dr. B. had taken coffee at breakfast, 
and found it an excellent support to the stomach and nervous system, 
while tea had dist^urbed his digestion and his mind; and that the former 
was a beverage of excellent qualities, while the latter was detestable ; 
— that Dr. C. had always drank both tea and coffee, and recommended 
them to everybody; — and that Dr. D. had himself never been able 
to indulge either tea or coffee, and would have them both expelled 
from every household. 

The discussion was not creditable to the learned and really able 
men who participated in it. The arguments were all based upon the 
miserably narrow basis of single individual experiences. They were 
no more valid than that of the man who should hold up a shoe, de- 
claring it fitted his foot the best of any he ever had, and recommend- 
ing all men to have their shoes made upon the same last. 

The truth is, there is but one thing which can be affirmed universally 
of the effect of tea and coffee. They both, when taken, tend to prevent 
waste in the body, and, consequently, less food is required when they 
are used. This may be affirmed of them in their applicability to all 
persons, but nothing further. The truth is, some can drink tea but 
not coffee, and some coffee but not tea ; some can use both, and some 
neither. Every man's susceptibility to the effects of these beverages 
is his own, as much as his susceptibility to the effects of light, or heat, 
or atmospheric changes ; and these effects, each person must learn 
from experience. Coffee often produces, and generally aggravates, a 
bilious habit, — an effect which cannot, I believe, be traced to the use 
of tea. 

Water. 

There is one universal beverage ; it is water. All men are fond 
of it. In sickness and in health, in joy and sorrow, in summer and 
winter, in cold climates and in hot, man loves and drinks water. The 
stomach, abused and made sick by stimulating food and drinks, and 
repelling everything else, still gratefully opens itself to water. Wher- 
ever man exists, therefore, or wherever he should exist, water is found, 
either in the form of springs, or running brooks, or rivers, or ponds, 
or lakes ; and even where it is not found in some of these forms, it is 
periodically dropped down from the clouds. As there is no element 
in nature more necessary for man's existence than water, so there is 
none more universally diffused. 

Pui'e Water Essential to Health. — But water varies very materially, 
both in its physical qualities, and in its adaptation to its purposes. 
Pure water is as essential to health as pure air. When either of these 
fluids is rendered impure by mixture w^ith foreign matters, disease 
will be a frequent result. The ancients must have been influenced 
by this fact, or they would not have incurred such heavy expenses in 



86 HYGIENE. 



procuring pure water from great distances. The strong aqueducts 
through whicli, for many miles, large streams of water are at this day 
poured into fallen Rome, attest the freeness of the expenditures she 
made for this purpose in the day of her renown. We may pity the 
ancient Romans for being governed in their military operations by the 
opinions of augurs and soothsayers, and certainly these things were 
silly enough ; but in other things, at first view equally superstitious, 
they showed practical wisdom. Vetruvius reports that in selecting the 
sites of their cities, they inspected the livers and spleens of animals to 
learn the salubrity of the waters and the alimentary productions of the 
region. The size and condition of these organs do in fact indicate 
the nature of the pasturage and the qualities of the water with which 
animals are supplied. No people can enjoy good health, when sub- 
jected to the double influence of bad water and impure air. 

Division of AVater. — The simplest division of water is into two kinds, 
soft and hard. Rain, river, pond, and snow water is soft ; well and 
spring w^ater is generally hard. Soft water contains but little impu- 
rities, and when used for washing, forms a good lather with soap. 
Hard water contains at least one of the salts of lime, often more ; 
mixed with soap, it curdles and turns white. The reason of this is, 
that the oily acids of the soap unite with the lime, and form a com- 
pound which the water will not dissolve. Such water is not suitable 
for domestic purposes. 

Chemical \atiire of Water. — Water contains, reckoning the ele- 
ments of which it is composed in volumes, one volume of hydrogen, 
and half a volume of oxygen. These two gases, the unlearned 
reader will please to remember, are highly subtle bodies, not visible to 
the eye ; and yet, when chemically united, they form a liquid which 
covers two-thirds the entire surface of the globe, — floating upon its 
bosom the navies and merchant ships of all nations, and, by its un- 
measured depths, and vast breadths, and sublime movements, fills the 
thoughtful mind with conceptions of creative Power, which words 
never attempt to express. Should the two gases which compose 
this vast body of water cease to love each other, and fall asunder, 
the first lighted taper would set the world on fire, and not a living 
being upon its surface could escape destruction. 

Impuiities iu Water. — It is not surprising that a fluid with as great 
a solvent power as water, should often dissolve and hold in solu- 
tion a great many impurities. In passing along through the earth, 
before it comes up in springs and wells, it is filtered through various 
mineral earths, and becomes contaminated accordingly. In running 
through beds of limestone, it takes up a little carbonate of lime. 
Salt beds impart to it common salt (muriate of soda), while sulphur 
and other ores tinge it with salts of various kinds. 

Water from the wells of Boston, formerly used by the inhabitants, 
was largely impregnated with common salt, and other mineral substan- 
ces. So marked was the saline taste, from this cause, that the New- 
Yorkers and Philadelphians used to say the Bostonians, when visiting 
their cities, had to salt their water. 



HYGIENE. 87 



Cochitirate Muter. — These wells, which so long yielded np brack- 
ish water to offend the palates of strangers, are now abandoned, and 
Boston is blessed by a copious stream of pure soft water, drawn 
through a line aqueduct from Cochituate Lake, twenty miles distant. 
This water is distributed to about every house and shop in the city. 

The result is, that the health of the citizens has been materially 
improved. Fevers, particularly those of the typhoid type, have dimin- 
ished, both in prevalence and fatality. The decaying vegetable and 
animal matter, so much of which gets into the commoii sewers, and 
which, in former years, sent up poisonous gases to attack the life of 
the citizens, are now washed away by the soft water, which is daily 
and hourly dropping through the sinks of all the dwellings of the 
city. 

Schuylkill and Crotoii Waters. — The Schuylkill water, introduced 
into Philadelphia, and the Croton, brought from quite a distance to 
New York, are both good waters ; though neither, as chemical analy- 
sis has shown, is quite as pure as the Cochituate, of Boston. 

Lead Pipes. — In each of these three cities, water is conveyed 
through the dwellings in leaden pipes, — a practice fraught with a 
danger to which the inhabitants should not expose themselves. That 
lead does often become oxidized and impart its poisonous properties 
to water when long in contact with it, is a well-known fact. Let a 
number of persons drink every morning from the first water drawn 
from the pipes, and a portion of them will be attacked with some 
form of lead disease. The pipes should be emptied every morning, 
before using the water for domestic purposes ; and then, it is true, 
there is little danger. But where the work in the kitchen is done by 
hired persons, who have no appreciation of the danger, how is it to 
be known whether this act of safety is always carefully performed ? 
Water pipes should certainly be made of some other material. 

Physical and Other Properties of Water. — Good water is without 
smell, is perfectly clear, and in the mouth, has a soft and lively feel. 
When poured^ from one vessel to another, it should give out air- 
bubbles. Boiled and distilled waters have a vapid, flat taste. This 
is owing to their containing no carbonic acid gas or atmospheric air, 
— these being driven off in the act of boiling and distilling. A hun- 
dred cubic inches of good river water contains about 2^ of carbonic 
acid, and 1^ of common air. 

Carbonic acid is what gives to mineral, or soda water, its brisk, 
and even pungent taste. Without a portion of this acid and atmos- 
pheric air, water is perfectly insipid, and not fit to be used as a bev- 
erage. Hence, if it be boiled or distilled to clear it of earthy matters, 
we must expose a large* surface of it to the air, and shake it, that it 
may re-absorb from the atmosphere, what it has lost, and thus recover 
its taste. 

Rain Water is the Result of Distillation on a large scale, and would 
be insipid, like other distilled water, only that, after being distilled off 



88 HYGIENE. 



from the waters upon the surface of the earth, it recovers, while as- 
cending as vapor, the carbonic acid and atmospheric air. 

Fishes breathe air as well as land animals, and hence, lakes upon 
the tops of high mountains, where but little oxygen can be absorbed 
into the water from the air, are not inhabited by the finny tribes. 

The Snltiiess of the Ocean is simply the accumulation of the saline 
substances washed out of the bowels of the earth. 

The water which for thousands of years has been distilling off as 
vapor, from the surface of the ocean, is nearly pure. Being carried 
by the winds to the continents, it falls as rain, sinks into the earth, is 
filtered through mineral substances, comes to the surfaces in springs, 
is collected into I'ivers, and, with all its freight of mineral salts, is 
borne back to fhe ocean. Everything that water can dissolve, and 
carry down from the continents, finds a great depository in the ocean ; 
and as this has no outlet, the accumulation must go on without limit. 
Rivers w^hich flow into the ocean, contain from ten to fifty grains of 
salts to the gallon, — composed chiefly of common salt, sulphate and 
carbonate of lime, magnesia, soda, potash and iron ; and these are 
the constituents of sea-water. The time must come, in the history 
of our globe, when these salts will render the water of the ocean so 
dense that a man can no more sink in it than a cork can sink in fresh 
water. 

Cleaiismo' of Impure Water. — Impure waters should be cleansed 
before being used for domestic purposes. Distillation is the most 
perfect method of purification. Filtration through sand is a good 
method. It removes all suspended vegetable or animal matter, and 
all living animals. Boiling likewise kills all animals, and throws to 
the bottom carbonate of lime. It is this which constitutes the crust 
which lines tea-kettles in all regions where limestone exists. 

Settlers in a new country, should make it a prime object to find 
good water. This is of great moment. Their own health, and the 
health of their posterity is dependent upon it. Any soil, good or bad, 
is not worth half price, if it yield impure water. 

Reasons for Prizin«' Water. — Finally, we ought all'to prize water 
very highly, for it composes nearly eight-tenths of our entire bodies^ in- 
cluding our flesh, blood, and other fluids. Nay, we owe to it the very 
softness, delicacy, and smoothness of our persons. Our muscles, nerves, 
blood-vessels, glands, cartilages, etc., all play smoothly upon each other 
in consequence of water. Take all the water out of us, and we should 
be dry sticks indeed. All our comeliness would be gone. Nobody 
would or could love us. We should be walking reeds, shaken and 
sported with by every wind. Let us never forget how much we are 
indebted to water. 

Exercise. 

Animal life is conditioned upon exercise. "Without it health can- 
not exist, or life itself be continued for any great length of time. 



HYGIENE. 89 



Proper exercise communicates motion to every part susceptible of 
it. It expands the breast, contracts and relaxes the muscles, quickens 
the motion of the blood, moves afresh all the other fluids, and stirs to 
the centre the whole frame. INIore easy and perfect digestion, the 
nutrition of every part, and the proper performance of all the secre- 
tions and excretions, are the results of such exercise. 

A distinguished physician said : " I know not which is most neces- 
sary to the support of the human frame, food or motion." Some of the 
finest talents in the world are probably lost for the want of exercise ; 
for without it the mind loses its keen perception, and its bounding 
energy ; its power of application and its general scope. If men of 
great talents would give attention to exercise, the world would reap 
a larger harvest from their written thoughts. 

The arrangements of modern society have very much abridged the 
facilities for taking exercise ; but if Trenck in his damp prison, with 
fetters of seventy jx^unds weight upon him, could preserve his health 
by leaping about like a lion, most persons could do as much with the 
fetters of modern society upon their limbs. 

Must be Reji'iilar. — Exercise, to be of much service, must be regu- 
lar, — not taken by fits and starts, — a good deal to-day and none to- 
morrow ; but in reasonable measure every day. Occasional efforts, 
with intervening inactivity, only does mischief. 

Must be Pleiisurable. — It should be connected, too, if possible, with 
some pleasing occupation or pursuit. The movement of the limbs 
should carry us towards some place or end in wliich the mind feels 
an interest ; exercise will then do us most good. Hence, botanical 
pursuits, the cultivation of a garden, and the like, are often preferable 
to a solitary and aimless walk. 

Must uot be Excessive. — Exercise should never be carried so far as 
to produce great fatigue. Extremes are injurious ; and too much ex- 
ercise, especially by a sick or feeble person, may be as injurious as too 
little. 

No clothing should be thrown off after exercise, nor should one cool 
off by sitting in a draft of air. Very serious consequences often fol- 
low this practice. 

Not to be Taken After Meals. — It is not best to take exercise im- 
mediately after meals. The reasons for this caution have been ex- 
plained. It is true many laboring men go at once to their work after 
eating, without apparent injury. Yet they are strong, and can endure 
what those who use their brains chiefly could not. - And even they do 
not labor as easily and cheerfully immediately after dinner. 

Active and Passive. — Exercise is properly divided into active and 
passive. Walking, running, leaping, dancing, gardening, various sports, 
etc., are active. While sailing, swinging, and riding in carriages, are 
passive. Riding on horse-back is of a mixed nature, — being both 
active and passive. 

A few remarks upon these several kinds of exercise, will have a 
practical value to some of the readers of these pages. 

12 



90 HYGIENE. 



Walkiilj>* is one of the most gentle, easy, and generally one of the 
most useful of the active exercises. It is within the reach of all who 
have the use of their limbs, and is indulged at the expense only of a 
little shoe leather. To make it agreeable, the face is only to be 
turned to some favorite locality, and the mind put in communion 
with the voices of nature. 

To walk with the best advantage, the body should be kept upright, 
the shoulders thrown back, the breast projected a little forward, so as 
to give the lungs full play, and the air an opportunity to descend to 
the bottom of them. This attitude places all the organs of the body 
in the most natural position, and relieves them from all restraint. 
Walking then becomes a source of pleasure. The artist who bends 
over his pallet, and gets into a cramped position, is by this kind of 
walking relieved, and his body kept upright. Females, particularly 
of the wealthier class, are much more apt to neglect this species of 
exercise than males. 

It is not so in England. There it is no uncommon thing for ladies 
of high rank to walk ten miles a day ; and they do it in shoes of suffi- 
cient thickness to protect their feet from all dampness, and in clothes 
large enough to give their muscles full play. As a consequence, they 
enjoy excellent health, and in many cases, even retain their freshness 
and beauty to old age. 

A master of one of the vessels of our navy who spent some time, 
lately, in the British Channel, was several times invited lo spend the 
evening at Lord Hardwick's, where he made the acquaintance of two 
daughters of his lordship, who, in the drawing room, lie thought the 
most accomplished ladies he ever saw. Yet those young women, on 
two occasions, in company with other friends, walked miles to visit 
his vessel, once on a rainy day, clad in thick, coarse cloth cloaks which 
no rain could penetrate, and caring as little for wet weather as a 
couple of ducks. 

Good for the Studious. — For the studious, walking is a most capi- 
tal exercise. It varies the scenes so constantly, and brings the mind 
in contact with so many objects, that the monotony of in-door life is 
admirably broken. It was a maxim of Plato, that " he is truly a crip- 
ple, who, cultivating his mind alone, suffers his body to languish." 

Good ill Cold Weather. — Walking is valuable in cold weather, be- 
cause it exposes one to the cold atmosphere, and hardens the person 
against frosty weather, — a consideration of great consequence in 
countries which are subject to extremes of cold. 

Riumiiig* and Leaphig' are forms of exercise which should be in- 
dulged with prudence even by the young and healthy. For the feeble 
and the aged, they are entirely inadmissible. Used cautiously, in a 
system of regular training, they may help raise the bodily powers to 
a high degree of agility and endurance. The North American Indian, 
who is bred to the chase, runs with surprising swiftness, and for en- 
durance is scarcely excelled by his faithful dog. What training does 
for the Indian, it may do for the white man, who may chance to in- 
herit as good a constitution. 



HYGIENE. 91 



Tlie Game of Ball requires very active running, and for the young, 
it is an exceedingly healthful amusement. It tills the whole frame 
with a bounding spirit, and sets the currents of life running like 
swollen brooks after heavy rains. 

(iyiiiiia Sties. — The more active species of exercise have generally 
been included under the term gymnastics. Among the Greeks and 
Romans, feats of strength and endurance were supposed to confer 
honor. For this reason, and because war was a laborious calling, re- 
quiring bodily endurance and strength, their youth were trained in 
the most active exercises. Gymnastic games were with them at once 
the school of health, and the military academy. 

In England, during the middle ages, acts of parliament and royal 
proclamations were employed to regulate and foster those manly 
sports and exercises, which fitted the people for the activity required 
on theiield of battle. 

Those preparations for brutal wars would be unsuited to the pres- 
ent state of the world ; but the capacity for endurance which these 
trainijigs produced, could be most usefully employed in the laborious 
and scientific researches which modern advancement requires. Very 
few of our scientific men have sufficiejit hardness of frame to sus- 
tain them in their laborious studies. 

The heart diseases which prevail so extensively are the result, many 
of them, of violent exercise, taken, perhaps, from necessity, and prov- 
ing injurious because not a matter of every-day practice. Violent 
exercise, more than any other kind, m.ust be regular in order to be 
borne. 

Aeeded by Yoiiii«: Women. — Gymnastic exercises, and calisthenics, 
are particularly needed by our young women, to give them something 
of the robustness of our mothers, two generations back. For the 
want of them, they are dwindling away, and becoming almost worth- 
less for all the purposes for which they were made. 

In view of this want, I cannot but express my gratification here, 
that a high school for young ladies is now open in this city, under the 
care of the Rev. George Gannett and his lady, in which a large and suit- 
able room is set apart for the daily exercise of calisthenic and gym- 
nastic exercises, suited to the age. and strength of each pupil, under 
the instruction of an experienced teacher of their own sex. I cannot 
but look upon this school, offering, as it does, the highest advantages 
for a complete education in science and morals also, as the beginning 
of better things. 

Mcdenis Physically Inferior to the Ancients. Reason for it. — It is 

evident that the moderns are inferior in bodily strength to the ancient 
Greeks and Romans. Before the introduction of Christianity, men 
knew very fittle about the future, and therefore strove to make the 
most of the present. Hence, they took measures to ensure health and 
long life. It is true that a due regard to the welfare of the future, 
need not, and should not, prevent a care for the present ; but from 
various causes, to be referred to on a subsequent page, such has been 
the practice, to the manifest physical injury of the race. 



92 HYGIENE. 



Di)neiii«', when hedged aboat with proper restrictions and limita- 
tions, has great advantages as a physical trainer of the young. There 
are very few forms of exercise which give so free a play to all the 
muscles, and at the same time so agreeably interest the mind. Begun 
in early life, and pursued systematically, dancing imparts a grace and 
ease of motion which nothing else can give. For this reason alone, 
it should be cultivated as an art. 

Everyman and woman is often placed in circumstances in life where 
the possession of an easy carriage of body, and an unembarrassed 
manner, would be prized above gold. One's personal influence in the 
world is greatly increased by an easy, graceful manner. We all know 
how a polite manner wins, while a rough and uncouth one repels us. 

Wai'iiiiio' Apiiiist Excess. — While dancing has many things to re- 
commend it, there are also several considerations which should w^arn 
us against using it to excess, particularly in the ball saloons of fash- 
ionable life. So many muscles are called into play, the breathing 
is so much quickened, and the air breathed is often so impure, that 
the circulation of the blood is hastened almost to fever excitement. 
And when to this we add the use of wines and cordials, alternated 
with ices and iced drinks, and the exposure, on returning home from 
balls, to the chill night air, under the miserable protection of insuffi- 
cient clothing, we have draw-backs enough to abridge, if not to anni- 
hilate the benefits derived from this otherwise healthful and elegant 
exercise. 

But then it will be said, and truly enough, that these are the abuses, 
not the uses of dancing. To these abuses, no parent should permit 
the health of a child to be exposed. In the parlor at home, in con- 
nection with a few young friends gathered in to spend an evening ; 
or, in a wxll-ventilated hall, under the instruction of a master of 
known character and refinement, dancing is of high utility, and much 
may be said in its favor. An amusement for which there is so gen- 
eral a fondness, one may say, passion, must be fitted to meet some 
want of the animal economy, and perhaps of man's higher nature. 

Grace of motion gratifies our sense of the beautiful, and in its 
nature is alhed to poetry. Turning away from the abuses of dancing, 
let the reader thankfully use it as one of the very best physical, social, 
and aesthetical educators of youth. 

But if dancing is salutary, it is only when every limb and muscle 
is allowed to participate naturally and without restraint in the general 
motion. When performed in a dress so tight as to restrain all free- 
dom, not only is every grace destroyed, but injury of a serious char- 
acter may be the result. 

Tlie Cultivation of a Garden is also a species of exercise highly 
conducive to health. To the poor it should have a double attraction. 
It is not only a healthful exercise, but it yields, in its season, many 
wholesome vegetables, the price of which, when they have to be pur- 
chased, frequently puts them beyond the reach of the poor. It is 
pleasant to know that in the towns of Massachusetts, where shoes 
are largely manufactured, most of the workmen own small pieces of 



HYGIENE. 93 



ground which they cultivate as gardens, — deriving health both from 
the labor, and from the vegetables raised. This is one of the kinds 
of exercise which are more beneticial from having an end in view. 
The man who works in his garden derives pleasure from the im- 
provement he is making upon his ground, and from the prospect of 
advantage to himself and family. 

Other Active FAercises. — To the exercises already spoken of may 
be added those which are mostly taken indoors, — the dumb-bells, 
jumping the rope, the battle-door, etc. They may be resorted to 
when the weather is stormy, or when any other cause may prevent 
one from going into the open air. Nevertheless, as promoters of 
health, they are inferior to those exercises which take one out under 
the open sky. They are too mechanical in their nature, and have too 
little aim, to be allowed to take the place of the preceding. 

Passive Exercises. 

Sailing'. — This, to many persons, is among the most pleasurable 
and exciting of the passive exercises. But the excitement arising 
from the motions of a boat, sometimes, in case of timid persons, 
degenerates into /<?«/*, which is injurious. Young gentlemen who 
manage the boat upon sailing excursions, should never put on too 
much sail in a brisk wind, and torment the ladies by exciting their 
fears, as their own amusement may be in this way purchased at the 
cost of others' health, — a result far enough from their thoughts or 
intentions, but not the less real. 

Swiii2,'iii<i,'. — The sick may sometimes indulge in this exercise, when 
capable of enduring no other. To swing gently has a soothing effect, 
and often allays nervous irritability in a way which nothing else can. 
It is like the lullaby motion of the cradle. It calms and soothes. 

Nervous children and grown persons in feeble health, are some- 
times, by roguish boys, swung too high, and very much excited and 
alarmed. This is wrong. It may do great injury. Very few boys 
would do it if they knew the evil consequences. Boys and girls are 
generally kind hearted ; and though they may like to hector others, 
they will seldom knowingly injure them for their own amusement. 

Ctimag'e-Ridiug'. — The advantages to be derived from this species 
of exercise are probably rated too high. For feeble persons, just re- 
covering from illness, who cannot endure walking or riding on horse- 
back it is valuable, particularly if taken in an open carriage. But for 
those who have more strength, it is less desirable than many other ex- 
ercises. True, it is generally an agreeable mode of locomotion, and 
for this reason, it is generally more serviceable than the small amount 
of exercise afforded by it would lead one to suppose. 

Carriages are luxuries, and like all other luxuries, they are apt to 
bring on debility, and perhaps shorten life. A man is apt to order 
his carriage to the door at the time when increasing wealth enables 
him to retire from the active pursuits of life, — the very moment when 



94 HYGIENE. 



he is most in need of some exertion to take the place of that to which 
he has been accustomed. Yet so it is, luxury comes to enfeeble, at 
the time when we need something to harden us. 

Could rich men be persuaded to let their luxuries consist, in part, 
in doing good, and like Howard, find pleasure in travelling on foot to 
visit those who are sick and in prison, they would be surprised to see 
how their happiness would be increased. 

Close carriages are generally used by the wealthy. They at best 
contain but little air, which is breathed over and over, and becomes 
unfit for respiration. The windows of such carriages should always 
be open, except in rainy weather, when the latticed windows only 
should be used. 



Ridiiio' in Sleig'lis furnishes an agreeable excitement, and may be 
indulged to some extent with advantage. Yet it can be had only in 
cold weather, and persons who partake of its pleasures, should be 
careful to wear clothing enough to protect themselves against the 
frost. This is the more necessary, as very little motion is communi- 
cated to their bodies by the sleigh. 

Horse-Back Riding*. — This form of exercise may fairly rank next 
to walking ; in some states of the system, it is preferable. It justly 
holds a high rank as an exercise for consumptive persons. Many a 
man, and woman too, has been benefited by it when suffering from 
lung disease. For those who have hernia^ or falling of the bowel, it 
is not proper, as the most serious consequences may result from its 
use. 

Tlie Horse Shonid be On^iied. — A feeble man who rides on horse- 
back should, if possible, own his horse ; for, becoming attached to him, 
as he generally does, he will be able to ride farther than upon an ani- 
mal in which he feels less interest. A horse is a noble creature, and a 
man who loves him, will sometimes acquire a passion, almost, for 
being upon his back, and witnessing his splendid performances. 

PleasimiMe Exercises Most Beneficial. — Finally, those exercises are 
most beneficial, and can be longest endured, in which we feel the 
greatest interest. Place before even a feeble man some desirable ob- 
ject, and he will endure a great deal to reach it ; or engage the mind 
of a very tired person in something which greatly interests it, and 
considerably more exertion will be easily borne. This is well illus- 
trated by the story told by IMiss Edgeworth of a certain father, who 
had taken a long walk with his little son, and found the boy appar- 
ently unable to walk further, some time before reaching home. " Here," 
said the shrewd-mi nd(^d father, "ride on my gold-headed cane." Im- 
mediately the little fellow was astride the cane, which carried him as 
safely home as the freshest horse. 

Mentil Co-operatioii is of the highest importance in all exercise. 
I\Icn who are paid by the job, work with far more spirit than those 
who are paid by the day. One would dig in the earth ^^n\\\ very little 
spirit, if he had no motive for doing it ; but if he expected with evciy 



HYGIEXE. 95 



shovelful of earth to bring up gold-dust, he would not only work with 
a will, but would endure a great deal more labor. From these consid- 
erations we may infer that those farmers and manufacturers, who pay 
their men the highest wages, make the most money on their work. 

Tlie best time for takiiis: exercise is that in which it does us most 
crood. For most persons, the morning hours may be considered most 
favorable. But there are many who cannot take exercise in the early 
morning, without suflering from it through the whole day. Some are 
able to walk miles in the afternoon, who would be made sick by sim- 
ilar exertions immediately after rising. 

Persons often injure friends who have this peculiarity of constitu- 
tion, by urging them out in the morning. They do it from good 
motives, but are, nevertheless, blameworthy for attempting to advise 
in matters which they do not understand. 

Rest and Sleep. 

Our bodies are like clocks ; they run down and are wound up once 
every twenty-four hom's. Were they obliged to work on uninter- 
ruptedly, they would wear out in a few days. It is a merciful pro- 
vision that periods of repose are allotted to us. Everything has its 
proper place. Rest is not less a luxury after exercise, than exercise 
is after rest. They both confer happiness at the same time that they 
promote our well-being. 

Sleeping' Rooms. — Tlie largest part of our rest is taken in sleep. 
Of course the kind of room in which we sleep is worthy of considera- 
tion. Hufeland says : " It must not be forgotten that we spend a 
considerable portion of our lives in the bed-chamber, and consequently 
that its healthiness or unhealthiness, cannot fail to have a very im- 
portant influence upon our physical well-being." It should at least 
be large. That is of prime importance, because, during the several 
hours that we are in bed, we need to breathe a great deal of air, and 
our health is injured when we are obliged to breathe it several times 
over. We should at least pay as much attention to the size, situa- 
tion, temperature, and cleanliness of the room w^e occupy during the 
hours of repose, as to the parlors, or drawing-room, or any other 
apartment. And yet how different from this is the general practice 
of families. The smallest room in the house is commonly set apart 
for the bed and its nightly occupants. 

The sleeping-room should have a good location, so as to be dry. 
It should be kept clean, and neither be too hot nor too cold. And 
more important still, it should be well ventilated. 

One bed, occupied by two persons, is as much as should ever be 
allowed in a single room ; though, of course, two beds in a large 
room, are no more than one in a small one. Both are objectionable. 

Fire in Sleepino* Rooms. — As to having fire in a sleeping room, 
that is a matter to be determined by the health of the occupant. 
Persons who have poor circulation, and are feeble, had better have a 



96 HYGIENE. 



little fire ia the bed-chamber, in cold weather. For those in good 
health, a cold room is preferable. 

Open AViiidows in Sleeping' Rooms. — In the hot weather of sum- 
mer, it is better to keep the windows open to som'e extent, through 
the night, but not on opposite sides of the room so as to make a draft 
across the bed. 

There is a difference of opinion as to the safety of this practice ; 
but the experience of those who have used it prudently and persever- 
ingly, has generally sanctioned its employment. It is presumed that 
night-air is made to be breathed ; and if we breathe it habitually, there 
is no good reason why it should be considered hurtful. At all events, 
we have got to do one of three things, — either breathe it, or be poi- 
soned by air which is breathed several times over, or use very large 
sleeping rooms, and thus lay in a stock to last over night. 

An Open Fireplace in a bed chamber will do nmch towards its puri- 
fication. It carries off foul air. But many persons board up this 
outlet as if bad air were a friend, with whom they could not think of 
parting. At the same time, they will carefully close all windows and 
doors, as if fresh air were an enemy not to be let in. 

Beds. — It is a pleasant thought that while so many things which 
injure health are coming into fashion, some which have a like effect 
are going out. Among tb? injurious things which are silently with- 
drawing, are feather beds. 

In earlier times, a bed made of eider-down w^as thought to be a 
great luxury, to be carefully 'preserved, and handed down from mother 
to daughter. Beds made of hens' feathers, and other coarser kinds, 
were thought to be only fit for children. With due deference to these 
earlier judgments, it must be said that feather beds, whether downy 
or coarse, are not even fit for children. They are composed of ani- 
mal matter, and by a slow process of decay, are always, when stirred, 
sending up an exhalation which it is not healthful to breathe. 

By their softness, too, they increase the general tendency to effemi- 
nacy. In warm weather, they are too heating. To sink down into 
them, and lie nearly buried all night, is to insure a feeling of lassitude 
and debility in the morning. Only the strongest persons can endure 
it without being made conscious of the evil effects. 

Beds mnst not be too Hard.— On the other hand, it is almost 
equally unwise to choose a bed of absolutely unyielding hardness. 
When very tired, we may rest even upon a board; but sleep will 
generally be more sound as well as refreshing, if the bed be some- 
what yielding. The hair mattress is the very best bed yet used. It 
is healthful and easy. No person once accustomed to it, will ever 
return to feathers. In summer, it is a luxury ; in winter, it is suffi- 
ciently warm, though a little more covering is needed than with 
feathers. 

Beddino'. — In hot weather, linen sheets are preferable to cotton, 
and of course will be used by those who have ample means. But 



HYGIENE. 97 



cotton ones are good enough, and in winter are decidedly the more 
do:<irable of the two. Cotton is best, too, for those who suffer with 
rheumatic affections. For external covering, comfortables are objec- 
tionable, because they do not let the insensible perspiration pass off 
as freely as it should. They are light, however, and so are rose 
blankets, which have the additional good quality of being porous. 
AVe should sleep under as few clothes as possible, consistently with 
comfort. 

\ijfht Dress. — The flannel, cotton, linen, or silk, worn next the 
skin through the day, should always be replaced, on retiring, by a 
suitable night-dress. ' This should be of the same material with that 
which is taken olT. If we wear flannel through the day, we need it 
quite as much at night. 



Do not Cover the Face. — The practice of sleeping with the face 
entirely covered with the bed clothes, is very injurious. It compels 
one to breathe the air over several times. 

Natural Position for Sleep. — The most natural position in which 
to sleep is upon the right side. This aflbrds the easiest play to the 
internal organs. It is best, however, to learn to sleep in different 
positions, and to change occasionally from side to side. Upon the 
back is not so easy a position. To lie in this way obstructs the cir- 
culation of the blood, by the pressure of the stomach, bowels, etc., 
upon the large blood vessels which pass down and up in front of the 
back bone. // is very tiresome and injurious to lie with the hands 
above the head. • 

Amount of Sleep. — The average amount of sleep required by per- 
sons in health, is from seven to eight hours. Occasionally we find 
persons who get along very well with six, or even five hours ; while 
some, even in health, require nine. There is no absolute standard for 
all persons, in the amount of sleep, any more than in that of food. It 
depends on the temperament, the constitution, the amount of exercise, 
and the exhausting nature of the mental application. 

The object of sleep is to repair the energies ; the extent to which 
they are wasted, and the recuperative power possessed, will measure 
the amount required. 

Late Suppers. — These are a bar to all sound and healthful sleep. 
The last meal should always be taken at least three hours before re- 
tiring, and should be light. During sleep^ the stomach should have a 
chance to rest. It will work the better on the morrow. Some per- 
sons boast that they can sleep perfectly well after a heavy supper. 
Perhaps they can ; but, as Franklin has wisely suggested, they may 
by and by " have a fit of apoplexy, and sleep till dooms day." This 
will be sleeping too ivell ! 

Preparation for Sleep. — Dr. Franklin left behind the record of a 
wise life, as well as many excellent moral and philosophical direc,- 
tions. A good conscience was his prescription for quiet sleep and 
pleasant dreams, — a most excellent direction. Sleep is promoted, 

13 



98 HYGIENE. 



too, by withdrawing the mind, a short time before retiring, from all 
hard study, and exciting themes of conversation ; and turning it to 
calmer subjects of reflection, such as the moral attributes of God, — 
particularly his love and paternal character. 

Objects of Clothing. 

The clothes we wear are intended, or should be intended, to secure 
three objects, — warmth in winter^ coolness in summer^ and health at 
all times. 

It has already been shown that our bodies are warmed by their 
own internal fires. In the lungs, in the skin, and indeed in all parts 
of the body, oxygen unites with carbon and other combustible mat- 
ters, producing heat in the same way that it is produced in a grate 
where anthracite coal is burned ; and as our temperature always 
needs to be kept up to about 98^^ of Farenheit, it follows that this 
combustion must always be going on. 

Now, the atmosphere which surrounds us is always receiving into 
itself the heat which comes to the surface of our bodies, and thus 
robbing us of our warmth. In summer, the atmosphere, full of the 
rays of a burning sun, may impart heat, instead of taking it away; 
while in winter, it takes more than it gives, and would cause us to 
perish with the cold, were it not for the protection afforded by our 
clothing. 

Clothes, of course, have no power to manufacture or impart heat. 
They only retain, and keep in contact with our bodies, that which is 
generated within us. If we have on a single garment which is made 
tight at the bottom and top, so that no current can pass up or down, 
there will be a layer of air between it and the body, which, becoming 
immediately heated, and being retained there, helps keep us warm, or 
rather, prevents us from being cold. With every additional garment 
put over this, there is another layer of heated air, adding still more 
impenetrable guards against either the intrusion of cold, or the escape 
of internal heat. 

Bad Conductors of Heat. — But, that our clothes may thus retain 
our warmth, and prevent its dispersion, they must be bad conductors 
of heat, — that is, they must not readily take up the heat and convey 
it away from the body. They must slowly absorb the caloric into 
their own substance, and then retain it tenaciously. 

Linen, wdiich is so universally popular in temperate climates, as an 

article to be worn next the skin, is unfortunately a good conductor of 

heat. It does not afford a warm garment. It conducts heat rapidly 

Fig. 67. away from the body. Hence it always feels cool 

to the touch. It is really no colder in itself than 

other kinds of cloth, but it is solely the rapidity 

with which it conducts heat away from the 

body, that gives it the feeling of coldness. It 

has other qualities which compensate, in some 

measure, for this defect. The fibres of which it is composed, are 




HYGIENE. 99 




rountl and pliable, which make linen cloth smooth and soft, and the 
sensations produced by it, upon the skin, altogether agreeable. Figm-e 
67 represents a fibre of linen, as it appears under a microscope which 
magnifies it 155 times. 

Cotton is warmer than linen, because it is a ivorse conductor of 
heat. The perfection to which its manufacture has been carried, 
makes it almost a rival of linen in softness and pliability. It does 
not absorb as much moisture as linen, and therefore better retains 
its powers as a non-conductor. 

But then the fibres of cotton are not round and smooth, like those 
p,j^ gg of linen, but flat and spiral, with sharp edges. 

Figure 68 represents two of its fibres, magnified 
155 times. This renders cotton irritable to some 
very delicate skins. This is the reason why linen 
is better than cotton for binding up wounds, 
where there is tenderness of the surface. 

Silk has a round fibre, like linen, which is even softer and smaller. 
It absorbs less moisture than cotton, and in its power of communi- 
cating warmth, it is superior to both the preceding. It forms the 
most desirable fabric for clothing that we have ; but its cost makes it 
inaccessible to the great body of the people, except as a holiday 
dress for the ladies. Its culture in our own country, if once exten- 
sively established, would be a source of national wealth. 

Tlie Fibre of Wool is quite rough, almost scaly, and highly irritative 
to delicate skins. Figure 69 shows fibres magni- ^^^ gg 

fied 310 times. It is not possible for some per- 
sons to wear it next the skin. But where this 
cannot be done it may be worn outside the linen 
or cotton ; and being a good non-conductor^ it will 
in this way preserve the warmth of the body, 
without either irritating the skin, or disturbing 
its electricity. 

Wool, in cold climates, is one of the very best 
materials of which clothes can be made. In New 
England, and, indeed, in all cold and temperate regions, it should be 
worn by delicate persons, in the form of thick or thin garments, all 
the year round. It does not readily absorb moisture, and is a dry, 
warm, and wholesome material for clothing. 

Hair Though not precisely in the line of these remarks, hair may 

as well be introduced here. Wool is in fact hair. Every part of the 
skin, with the exception of that upon the soles of the feet, and the 
palms of the hands, is intended to produce hairs. On most parts of 
the body, they are short and fine, hardly rising above the surface. 
Upon the head and the face, they grow to considerable length. 

Hair, like wool, is a bad conductor of heat ; and, as growing upon 
the head and face, is doubtless intended for some useful purpose. 
That it was designed as a warm covering, can hardly be doubted. 
The beard, when permitted to grow, is a natural respirator, guarding 




100 HYGIENE. 




the lungs against cold and dust. Mr. Chadwick noticed that black- 
smiths wlio allowed their beards to grow, had their mustachios discol- 
ored by iron dust, which lodged among the hairs, and very justly in- 
ferred that the dust must have found its way into the lungs, and done 
mischief, had it not been arrested by this natural respirator. 

That the beard, when long, does ward off a great many colds and 
throat ails, is too well known to be denied. It has required moral 
courage on the part of those who have broken away from the univer- 
sal practice of shaving, for which they should be hon- ^^^ ^q 
ored rather than ridiculed. For those who do not suffer 
from throat or lung complaints, especially if they are 
getting advanced in life, it may not be thought worth 
while to abandon the razor. Yet the change would not 
be regretted. Figure 70 is a human hair, magniiied 250 times, show- 
ing its scaly surface. 

The Color of onr Clothing* is a matter of some moment. The dark 
colors absorb the light, the sun's rays, and heat, much more than the 
lighter ones ; and as those bodies which absorb heat well, are like- 
wise good radiators, the dark colors have the highest radiating poiver. 
White reflects heat, and rays of light, and is a bad absorber and bad 
radiator. In summer it prevents the sun's rays from passing inward 
to heat the body, and in v.- inter, interrupts the heat of the body in its 
passage out. In summer, it makes the coolest garment ; in winter, 
the warmest one. These facts can be very simply illustrated, by lay- 
ing, side by side, upon the snow, when the sun shines, two pieces of 
cloth, the one black, the other white. Lifting them up, after a time, 
the snow will be found considerably melted under the black cloth, but 
not under the ivhite. 

It is now seen that the object of clothing is not to impart heat to 
the body, but to prevent its loss ; that it is not to create it, but to 
furnish the occasion for increasing its degree. It appears further, that 
clothing protects the body against the evil effects of changes of tem- 
perature, and that white garments, by reflecting, instead of absorbing 
heat, guard it against the heat of summer. 

Clotliiug' should be Porous. — All articles used for garments, should 
be porous, and permit the free passage of insensible perspiration. The 
skin receives oxygen through its pores, and gives back carbonic acid. 
It performs a sort of subordinate respiration. India rubber garments 
worn next to it, interrupts this, and must do mischief Shoes made 
of this material, soon cause the feet to become damp and cold. The 
dampness is occasioned by the insensible perspiration, which cannot 
escape through the rubber. Such shoes worn in the open air, should 
be immediately taken off' on entering the house. 

Thin Shoes, — The defective way in which American females pro- 
tect their feet from cold and wet, is a sore evil ; and he who persuades 
them to adopt a wiser fashion, and cover their feet with better guards 
against colds and consumptions, will deserve the gratitude of the 
nation. We are in many things too fond of copying foreign fashions ; 



HYGIENE. 101 



bin if our ladies would, in this matter, follow the excellent example 
of English women, they would live longer, and leave a hardier pos- 
terity behind them. 

The shoes worn by our females, high and low, rich and poor, are 
not thick enough to walk with safety upon a painted Hoor, hardly 
upon a carpet in an unwarmed room ; and yet they walk with them 
upon cold brick side-walks, upon damp and frozen ground, and even 
in mud. 

The result is, that they suffer from colds, sore throats, pleurisies, 
lung fevers, suppressions, inflammations of the womb, and many other 
ailments, which in early life, rob them of their freshness and beauty, 
of their health and comfort, of their usefulness to their household and 
the world, and leave them helpless in the arms of their friends, with 
a patrimony of suffering for themselves while they live, and a legacy 
of disease to hand down to their children. Would that they were wise 
in season I Some, to their honor be it said, have already adopted a 
safer course. It is hoped the evil will be gradually corrected. 

iVever attempt to mould the Form l)y Dress. — Parents commit a 
great error when they attempt to mould the forms of their children, 
particularly their daughters, by their dress. This cannot be done. 
It is the work of nature, and she wants no assistance in it. The 
great object of dress in childhood as well as in adult life, is to pro- 
mote health. With t/iis, there is not much difficulty in preserving the 
symmetry ; icithoiit it., deformity is almost a matter of course. 

The fact cannot be too often repeated, nor too seriously urged upon 
parents, that while the foundation of all graceful and just proportion 
of the different parts of the body must be laid in infancy, it cannot 
be done by tight bands, and ligatures upon the chest, and loins, and 
legs, and arms. Upon all these points, the garments of children 
should set easy, leaving the muscles at liberty to assume the fine 
swell and development which nothing short of unconstrained exercise 
can give. Could infants tell all the horrors they suffer from the re- 
straints put upon them by tight dresses, it would make many a moth- 
er's heart bleed. 

In these brief remarks, the principles are given which should guide 
us in the selection of our clothing. The intelligent reader will be 
able very easily to fill up the outline. 



Bathing and Cleanliness. 

Aristotle calls cleanliness one of the half virtues ; and Addison, 
in the Spectator, recommends it as a mark of politeness, and as analo- 
gous to purity of mind. Both in the Jewish and Mohammedan law, it 
is enforced as a part of religious duty. Its requirement as a prerequi- 
site to christian communion, would be wiser than the demands some- 
times made. A dirty Christian may perhaps be found, but not among 
those who mean to be intelligent. 

The importance of keeping the skin clean is not generally appre- 
ciated. The motive for cleanliness is often a lower and meaner one 



102 HYGIENE. 



than should be allowed to have place in the mind. Many persons 
would be mortified to have their hands, or face, or neck dirty, who do 
not wash their whole body once a year. That they may appear well 
in the eyes of others, is the only motive with such for keeping clean. 

Offices of the Skin. — If we look a little at the offices of the skin^ 
we shall better understand the need of keeping it clean. 

The skin is not merely a covering to protect us from the weather. 
It is a living structure, curiously wrought, with a large extent of sur- 
face, and having important duties to perform in the animal economy. 
Its structure is more particularly explained under the head of " Anat- 
omy " and " Skin Diseases." It has been already said, that it helps 
the lungs in breathing. It does many other things on which the 
health is dependent. 

Xiuiiber of Perspiratory Tubes. — The skin performs several kinds 
of secretion, — that is, it separates several things from the blood, — 
one of which is the perspiration, or sweat. The sweat is formed in 
small glands, situated just under the skin, and is brought to the surface 
in small ducts, or tubes, like the hose through which firemen throw 
water. These little tubes are spiral, as seen in cut 44, and run up 
through the two skins. 

These spiral canals are very numerous, covering every part of the 
human frame, — there being about 2800 of them upon every square 
inch throughout the body ; and as a man of ordinary size, has about 
2500 square inches of surface, the number of tubes in the skin of one 
man is seven millions. 

The mouths of these tubes are called the pores of the skin. Each 
one of these tubes is extended just below the skin ; and there, among 
the cells where the fat is deposited, it, or rather the two branches into 
which it is divided, are wound into a coil, called the sudoriferous, or 
sweat gland. These ducts are each about a quarter of an inch in 
length, which makes an aggregate length of tubing in the human skin 
of about twenty-eight miles. 

Insensible Perspiration. — Through each of these seven million of 
quarter inch hose, there is poured out, day and night, as long as a 
man lives, a stream of sweat in the form of vapor. When this is 
thrown off very rapidly, as happens when active exercise is taken, it 
accumulates in drops, and is called sweat. Ordinarily it does not 
thus accumulate ; it is then called insensible perspiration, — not being 
recognized by the senses. 

This transpiration may be proved very beautifully by inserting the 
naked arm into a long glass jar, and closing up the space around it 
at the mouth so that no air can get in. The inside of the glass will 
soon be covered with a vapor, which will grow more and more dense 
until it is converted into drops. Boerhaave says : " If the piercing 
chill of winter could be introduced into a summer assembly, the 
insensible perspiration being suddenly condensed, would give to each 
person the appearance of a heathen deity, wrapped in his own sepa- 
rate cloud." 



HYGIENE. 103 



Now, this continual exudation of sweat through these millions of 
tubes is for a wise and necessary purpose. It is to take out of the 
blood and other fluids various salts, which would do mischief if 
allowed to remain longer, and particularly carbonic acid, which is 
poisonous, — the same matters, in fact, which are thrown out by the 
lungs. The skin, in truth, is a kind of helper of the lungs ; and a 
lady, by covering herself with garments which have no pores, and 
will neither admit air nor let otF insensible perspiration, may be stran- 
gled almost as certainly as by putting a cord around her neck, and 
closing her windpipe. Almost twice as much fluid passes oif through 
j the skin as through the lungs. 

Keep the Pores Open. — It is obvious from what has now been said, 

that the pores of the skin should be kept open to preserve health. 

When bathing is neglected, and the under garments are not changed 
, sufficiently often, the insensible perspiration accumulates and dries up 
; upon the skin, mingling with the oily matter secreted by the oil glands, 
\ and with the shreds of the scarf skin, and forming a tenacious gluey 
/ matter, which closes up the pores. By this misfortune, that large quan- 
i tity of worn-out matter which usually goes off with the fluid through 
i the pores, is retained to poison and embarrass the living current of 
[ blood, or seek an outlet through lungs or kidneys which are already 
; burdened with quite as much as they are able to do. How impor- 
j tant, then, that these channels through which the body is purified, 

should be kept open ! that the skin should be kept healthy and in 

working order I 

; The Batli, the Great Purifier. — But this can only be done by daily 
washing. The bath is the great purifier of the human skin. 

The antiquity of bathing is very great. The practice is supposed 
to reach back to the infancy of the race, or certainly to a very early 
period. The inhabitants of middle Asia are said to have been the 
first to use the bath for the specific purposes of purification and 
health. Domestic baths are represented as having been used by 
Diomed and Ulysses. Andromache prepared warm water for Hector 
on his return from battle. Penelope banished sorrow by unguents 
and baths. 

The Baths of the Medes, the Persians, and the Assyrians were much 
celebrated. Alexander, though familiar with the voluptuous baths 
of Greece and Macedon, was astonished at the magnificence of those 
of Darius. 

Roman Baths. — As luxury and refinement advanced,. the means of 
luxurious bathing were multiplied, until establishments were built by 
the Romans, the very remains of which excite wonder at this day. 
Among these are the Thermae of Agrippa, of Nero, of Vespasian, 
of Titus, etc. One of the halls of the building constructed for baths 
by Diocletian, forms at this day the church of the Carthusians, one 
of the most magnificent temples in Rome. 

^^imiber and Cliaracter. — According to Pliny, baths were intro- 
duced into Rome about the time of Pompey ; their first erection Dion 



104 HYGIENE. 



attributes to MsBcenas. Agrippa increased their number to one 
hundred and seventy ; and within two hundred years they were mul- 
tiplied to about eight hundred. These establishments were so vast 
that cue writer compares them to provinces. They were paved either 
with crystal, or mosaic, or plaster, and were adorned by sculpture and 
painting to the very highest degree. They added not merely to the 
health and luxury of the people, but contributed to their culture in 
the highest departments of art and taste. 

^^ames of Batlis. — To the apartment of their dwelling in which 
they washed their bodies in warm or hot water, the Romans gave the 
name of balneum^ or bath; to the public establishments, that of balnea^ 
or baths. The apartment which held the vessels was called vasarium. 
In this were the three immense vessels which contained the cold, warm, 
and hot water. There were instruments of bone, ivory, and metal, 
for scraping the skin, with a groove in the edge, through which the 
impurities of the skin might run off. 

On the north front of the thermae was a reservoir of cold water 
large enough for swimming, called by Pliny the younger, baptisteium. 
In the centre was a spacious vestibule, and on each side, warm, cold, 
and vapor baths, with apartments for cooling, dressing, and refresh- 
ments. There was the frigidaium^ a vaulted room, a cooling room 
midway between the warmer and the open air ; the tepidariuni, with 
a temperature widway between the above and the hot bath ; and the 
colidariiun^ or the vapor bath. 

Then there was the room where the body was rubbed over with a 
great number of ointments and essences of the most precious kinds ; 
and another in which it was sprinkled over with powder ; and also a 
room which held the clothes, in which the bathers undressed and 
dressed at pleasure. 

All these apartments were double, the two wings being appropri- 
ated to the sexes. 

Open to all. — These baths, thus numerous and magnificent, were 
open to all classes of the people, and contributed largely to the gen- 
eral health and physical endurance for which the Romans were con- 
spicuous. 

The Bath Xeglected under the Christian System. — "When Jesus of 
Nazareth came into the world, he found man's nature cultivated in a 
most defective way. The moral element had sunk down to the low- 
est place, Vv'hile the physical had risen to the highest, — just the reverse 
of the true order of things. This Divine Teacher came, not to re- 
commend a neglect of the body, but a new cure for the imperishable 
part. Mankind were for the first time systematically taught to forgive 
injuries. Prostrate liberty, and degraded woman, became the wards 
of Christianity. 

Unfortunately, under the new order of things, the lower element 
of man, which had been exalted and worshipped, was cast down and 
abused. What the Pagan had pampered, the Christian persecuted. 
The body, which had been bathed, and scrubbed, and anointed, and 



HYGIENE. 105 



perfumed, was thenceforward, in consequence of the improper inter- 
pretation of certain texts, scourged, and fasted, and clothed in rags. 
Thousands believed, and thousands do to this day, that to torment 
the body is to please God. Under this feeling, the public and private 
baths were neglected ; and to this day, no christian nation has fully 
appreciated the necessity of cleanliness, and of sanitary measures for 
the maintenance of the public health. To a considerable extent, the 
body is still under disabilities ; still the subject of persecution ; and 
where this is not the case, it is too often regarded only as a loose out- 
side garment, to be thrown over the traveller to the celestial city, and 
is expected to be well soiled with mud and dust. The teachings of 
the Great Master will by and by cease to be perverted, and will be 
applied to raise up man's body, as they have raised his mental and 
moral nature, and will make a well-developed and harmonious being. 
In the mean time, it is the duty and the privilege of the physician 
to uro-e a return, not to the magnificence of the ancient regimen for 
training the body, but to its real efficiency in a simpler form. 

Cold Bathinu,*. — Water applied to the skin at a temperature below 
75° of Farenheit, is called a cold bath. If applied to a person with 
sulFicient constitutional energy to bear it, it is a decided and very 
powerful tonic. By this is meant that it promotes the solidity, com- 
pactness, and strength of the body. 

The first effect of the application of cold water to the skin, is the 
sudden contraction of all its vessels, and the retreat of the blood 
towards the internal organs. The nervous system, feeling the shock, 
causes the heart to contract w^ith more energy, and throw the blood 
back with new force to the surface. 

This rushing of the blood back to the skin, is called a reaction ; 
and when it occurs with some energy, it is an evidence that the sys- 
tem is in a condition to be much benefited by the cold bath. When 
this does not take place, but the skin looks shrunken, and covered 
with " goose flesh," and a chilliness is felt for a longer or shorter time 
after bathing, then the inference should be, either that the water has 
been used too profusely, or that the bather has too little reactionary 
power for this form of the bath. The latter conclusion must not be 
accepted until cold water has been tried with all possible guards, — 
such as beginning with tepid water, and gradually lowering the tem- 
perature ; bathing for a time, at least, in a warm room ; beginning 
the practice in warm weather ; and applying the water at first with a 
sponge, out of which most of it has been pressed by the hand. With 
some or all of these precautions, most persons may learn to use the 
cold bath. It is always to be followed by brisk rubbing with a coarse 
towel or flesh-brush. 

The Spoiig'e Batli. — A wet sponge is the simplest, as well as the 
best mode of applying water to the surface of the body. With 
persons who are feeble, a part only of the body should be exposed 
at a time, — which part, having been quickly sponged and wiped 
dry, should be covered, and another part exposed, and treated in a 
like manner. In this way, all parts of the body may successively be 

14 



106 HYGIENE. 



subjected to the bracing influence of water and friction, with little 
- risk, even to the most delicate, of an injurious shock. The only fur- 
niture required for carrying out this simple plan of bathing, is a 
sponge, a basin, and a towel. There is no form of bathing so uni- 
versally applicable as this, or so generally conducive to health. 

The Shower Bath requires a brief notice. The shock, to the nervous 
system produced by it, is much greater than that from sponging. 
Beside the sudden application of coldness, there is a concussion of 
the skin by the fall of the water. This form of the bath is excellent 
for those who are strong and full of vitality, but is fraught with some 
danger for the feeble and delicate. This, however, depends on the 
judgment with which it is used. In the form of a delicate shower, 
and with tepid water, the frailest body might bear its shock. 

The AVarm Bath. — A temperate bath ranges from 75° to 85° ; a 

tepid bath, from 85° to 95° ; a warm bath, from 95° to 98° ; a hot 

.' bath, from 98° to 105°. A warm bath is of the same temperature 

with the surface of the body. Of course it produces no shock. To 

I those who are past the meridian of life, and have dry skins, and begin 

( to be emaciated, the warm bath, for half an hour, twice a week, is 

'i eminently serviceable in retarding the advances of age. 

•; It is a mistake to suppose the warm bath is enfeebling. It has a 

soothing and tranquillizing effect. It renders the pulse a little slower, 

and the breathing more even. If the bath be above 98°, it becomes 

a hot one, and the pulse is quickened. 

The temperature of the warm bath, as of the cold, should be made 
to range up and down according to the vigor of frame, and the circu- 
lation of the individual. The aged and the infirm, whose hands and 
feet are habitually cold, require it to be well up towards the point of 
blood heat. The pulse should not be made to beat faster by it, nor 
should sensations of heat or fulness be induced about the temples 
and face. 

The Vapor Batli. — This differs from the warm bath in being ap- 
plied to the interior as well as to the exterior of the body. The 
warmth is inhaled into the air tubes at the same time that it envel- 
ops the external person. The first sensation of the vapor bath is 
oppression, and causes some difficulty of breathing ; but this passes 
ofi' as soon as the perspiration begins to flow. From the steam- 
chamber, the bather should step into a tepid bath, and after remain- 
ing a short time in this, wipe himself thoroughly with dry towels. 

/ Cold Aflfusioil immediately after either the warm or the vapor bath, 
is excellent. In Russia it is common, after the vapor bath, to pour 
upon the head of the bather, a bucket of warm water, then one of 
tepid, and lastly one of cold ; and to finish with giving him a good 
towelling. It is even said that the natives leave the steam and the hot 
bath, and roll themselves in the snow. 

No danger need be feared from cold affusion when the skin is red 
and excited by the warm bath, provided the nervous frame is not in 
a depressed condition. If the body is chilled, and the nerves pros- 



HYGIENE. 107 



/trated by disease or fatigue, the application of cold water to the skin 
may do great mischief, and should in no case be hazarded. Cold 
water applied to a hot skin, cannot do harm ; to a cold skin, it can do 
nothing but harm. Hence, the cold bath may be used with advan- 
tage oti rising in the morning, while the body is warm. Another good 
time is at ten or eleven o'clock in the forenoon, when the nervous 
power is advancing towards its height for the day. 

Reaction Xeoessarj'. — As a means for promoting cleanliness, the 
importance of the bath can hardly be overstated. For the support 
and improvement of health, it is equally important. But for the pro- 
motion of the latter, one prerequisite is essential, — the reaction of 
the skin. 

Various means are resorted to, to secure this. The Hindoos secure 
it by a kind of shampooing, thus described by a writer : " One of the 
attendants on the bath extends you upon a bench, sprinkles you with 
warm water, and presses the whole body in an admirable manner. 
He cracks the joints of the fingers, and of all the extremities. He 
then places you upon the stomach, pinches you over the kidneys, 
seizes you by the shoulders, and cracks the spine by agitating all the 
vertebra, strikes some powerful blows over the fleshy and muscular 
parts, then rubs the body with a hair-glove until he perspires, etc." 
" This process," says the writer, " continues for three-quarters of an 
hour, after which a man scarcely knows himself ; he feels like a new 
being." Sir John Sinclair speaks thus of the luxury of the process : 
" If life be nothing but a brief succession of our ideas, the rapidity 
with which they now pass over the mind would induce one to believe 
that, in the few short minutes he has spent in the bath, he has lived a 
number of years." 

The Coarse Towel, the horsehair glove, and the flesh-brush are the 
appliances commonly used for stimulating the skin, and causing reac- 
tion. For tender skins, the towel is sufficiently rough. With this 
the bather should rub himself, unless he is weak and the exertion pro- 
duces palpitation. The muscular exertion necessary for this will help 
the reaction. 

Restoration of the Bath desirable. — It is greatly to be wished that 
the bath might be restored to something like the importance it held 
among ancient nations. It is a luxury, a means of health, and a 
source of purity both of body and of mind ; for the morals of any 
people will rise where the use of the bath is regular and habitual. 
The attempt to cure all diseases by what is called the " water-cure," 
has a bit of fanaticism about it, which will cure itself in time. But 
that water, used judiciously in the form of baths, is a potent moral 
and physical renovator of the race, is not to be doubted ; and this 
should commend it to all sensible people, even though it should some- 
times be abused by excess, as all good things are. 

A people with clean hands, and clean bodies, and clean health, will 
very naturally come to like clean streets and clean cities, and finally, 
clean consciences. A fondness for cleanliness in one form, almost 



108 HYGIENE. 



necessarily runs into a like fondness for it in other forms, until the 
purifying desire pervades the whole nature, moral as well as physical. 

Air and Ventilation. 

Water and air are fluids. Water covers two-thirds the surface of 
the globe, having a depth, in some places, of five miles or more. Air 
covers not merely the remaining third of the earth, but the water as 
well. It embraces the entire globe, pressing alike upon land and 
water, and having a depth of about forty-five miles. This is a sea of 
such magnitude, that the Atlantic or Pacific shrinks to a very small 
lake in the comparison. 

Man has his residence, and walks about at the bottom of this 
ocean. He has no means of navigating it, and, therefore, never rises 
to its surface ; but, with his natural eyes, and with telescopes, he dis- 
covers objects which lie millions and billions of miles beyond it, and 
even acquires much exact and useful information respecting them. 

This vast ocean of air we call an atmosphere, from two Greek 
words signifying vapor, and a sphere, — it being an immense fluid- 
sphere, or globe. 

Pressure of the Atmosphere. — This atmosphere presses upon man 
and upon every object on the surface of the earth, with a force equal 
to fifteen pounds to every square inch ; and as a man of average size 
has a surface of about 2500 square inches, the air in which he lives, 
presses upon him with a weight of eighteen tons. This would of 
course crush every bone in his body, but for the fluids within him 
which establish an equilibrium, and leave him unoppressed. 

The Philosophy of Breathiiio' cannot be fully explained in the brief 
space allotted to this subject ; it is enough to say, that, upon the at- 
tempt being made to draw in the breath, the muscles of the breast 
draw up the ribs, the diaphragm or midriff at the same time contract- 
ing, — the whole movement being such as to create a vacuum in the 
lungs. The air, pressing upon every part of the surface, as mentioned 
above, instantly rushes in and fills the vacuum. The lungs being 
filled, the contraction of the muscles of the belly causes the dia- 
phragm, which has sunk down towards a plane, to rise up into the 
form of an umbrella, and squeeze the air out of the lungs. 

This is about all that need to be said of the method of getting the 
air into and out of the lungs. The whole process is under the con- 
trol of that part of the nervous system called the medulla oblongata, 
or top of the spinal cord. 

Ohjects of Breathiiio\ — There are at least three objects to be ac- 
complished by breathing ; the renewal of the blood and the taking of 
impurities out of it ; the warming of the body ; and the finishing up 
of the process of digestion, and the change of chyle into nutritive 
blood. 

There is no good reason for attempting here to explain the last of 
these objects. To give any idea of the first two, it is necessary to 
furnish a very brief explanation of the circulation of the blood. 



HYGIENE. 109 




The heart is double. There are in fact two hearts, a right and a 
left, joined together. The right heart receives the blood from the 
veins, and forces it np into the lungs, whence it is brought back to 
the left heart, and by this is driven through the arteries into every 
part of the body. ^Vhen received into the lungs, the blood is of a 
dark purple color, and is loaded with carbonic acid and some other 
impurities. It has also been deprived, during its circulation through 
the body, of most of its oxygen. The small, delicate vessels which 
convey this dark and impure blood through the lungs, pass directly 
over the air cells ; and at this moment the carbonic acid and water 
pass through the blood vessels and air cells, and are borne from the 
body on the outgoing breath ; while the oxy- 
gen enters the blood through the walls of the 
same vessels ; and this exchange, which takes 
place with every breath, alters the blood from 
a dark purple to a scarlet red. Figure 71 
shows at 1, a bronchial tube divided into three 
branches ; 2, 2, 2, are air-cells ; 3, branches of 
the pulmonary artery winding around the air- 
cells with the dark blood to be reddened. 
That carbonic acid and water are borne out of the lungs with every 
breath, may be easily proved. If we breathe into lime-water, it will 
become white. This is owing to the carbonic acid in the breath 
uniting with the lime, and producing carbonate of lime. Then, if we 
breathe upon a piece of glass, it becomes wet, showing that there is 
watery vapor in the breath. That the blood receives oxygen from 
the air a ^e breathe is proved by the fact that the ingoing breath has 
one-fourth more oxygen in it than the outgoing. 

The lungs, then, take out of all the air we breathe, one-fourth of 
its oxygen. If we breathe it over a second, a third, and a fourth time, 
it not only has less oxygen each time, and is less useful for the pur- 
poses of respiration, but it becomes positively more hurtful by reason 
of the poisonous carbonic acid which, at every outgoing breath, it 
carries with it from the lungs. 

Effect of Sleeping' in a Small Room. — Now, consider the effect of 
sleeping in a small room, seven feet by nine, not furnished with the 
means of ventilation. A pair of lungs, of ordinary size, take in, at 
each breath, about a pint of air. Out of this air one-fourth of its oxy- 
gen is extracted ; and when it is returned from the lungs, there comes 
along with it about eight or nine per cent, of carbonic acid. As it is 
not safe to breathe air containing more than three or four per cent. 
of this gas, the pint which the lungs take in and throw out at each 
breath, is not only spoiled, but it spoils something more than another 
pint with which it mingles; and as the breath is drawn in and thrown 
out about eighteen times per minute, not less than four cubic feet of 
air is spoiled in that time by one pair of lungs. This is two hundred 
and forty feet an hour ; and in eight hours, the usual time spent in 
the sleeping room, it amounts to one thousand nine hundred and 
twenty cubic feet. During the hours of sleep, therefore, one pair of 



110 HYGIENE. 



lungs so spoil one thousand nine hundred and twenty cubic feet of 
air that it is positively dangerous to breathe it. 

In a room seven feet by ten, and eight feet high, there are five hun- 
dred and sixty cubic feet of air, a little more than one-quarter the 
amount spoiled by one pair of lungs during sleeping hours. In a 
room of this size, there is not air enough to last one person three 
hours ; and yet two persons often remain in such rooms eight or nine 
hours. 

Why then do they not perish ? Simply because no room is entirely 
air tight. Fortunately, all our rooms are so made that some foul air 
will get out, and a little that is pure will find its way in. Were it not 
so, no man ivho closed the door behind him, for the nig-ht, in a small bed- 
room, icould ever see a return of da?/. 

Suppose fifty children are confined in an unventilated school-room, 
twenty feet by thirty, and ten feet high. These children will spoil 
about one hundred and fifty feet of air in one minute, or nine thou- 
sand feet per hour, or tiventy-seven thousand feet in three hours, — a 
usual half day's session. But the room holds only six thousand cubic 
feet of air, — the whole of which these children would spoil in forty 
minutes. 

These simple facts show the absolute necessity of ventilation. Yet 
how poorly it is provided for in our sleeping rooms, our sitting rooms, 
our school houses, our churches, our court houses, our halls of legis- 
lation, and even in our anatomical and medical-lecture rooms I 

In sick-rooms, ventilation should receive special attention. — Every 
disease is aggravated by the breathing of bad air. Yet it is common 
to close all the doors and windows of rooms where sick persons are 
confined, lest the patients should take cold. This is a bad practice. 
The sick should have a plenty of fresh air. Their comfort is pro- 
moted by it, and their recovery hastened. 

It is strange that human beings should be afraid of pure air. It is 
their friend and not their enemy. Impure air only should be shunned. 

The supply of ^ood air ample, — There is no necessity for breath- 
ing air which has lost a part of its oxygen, and acquired a portion of 
carbonic acid. The supply of good air is ample. An ocean of it 
forty-five miles deep, covering the whole globe, seems a pretty plain 
intimation that it is not to be sparingly used. When men retire 
within their dwellings, and attempt to shut out this great sea of air, 
they show about as much wisdom as would be exhibited by fishes 
which should build water-tight huts around themselves at the bottom 
of the ocean, and swim about continually in the unchanged water 
within. Fishes can only live in glass globes when the water is 
changed every day ; and if the water be changed half a dozen times 
a day, they cannot be as healthy as when swimming in the great 
ocean. 

Cultivating- Trees. — In most of our cities there is almost a criminal 
neglect of the cultivation of trees ; yet they add greatly to the health, 
and prolong the lives of the citizens. 

The leaves of a tree are the lunsrs with which it breathes : but in- 



HYGIENE. 



Ill 



stead of extracting oxygen from the air, and giving back carbonic 
acid, like man, it takes only the poisonous carbonic acid, and gives 
back oxygen. 

Were there no animals on the gk)be, the vegetables would consume 
all the carbonic acid, and die for want of breathing material ; on the 
other hand, were there no trees or other vegetables, the animals would 
in time so far exhaust the oxygen as to perish for lack of it. The two 
together keep the air healthy for each. 

The relation of plants and animals, in all that relates to their pecu- 
liar actions and eflects, is a complete antagonism. Their movements 
are in contrary directions, and by hostile forces. Their opposing ac- 
tions may be illustrated thus : 



The vegetable produces the non- 
nltrogenized substances, sugar, starch, and 
gum. 

The vegetable decomposes car- 
bonic acid, water, and ammoniacal salts. 

The vegetable disenXtAges oxygen. 

The vegetable absorbs heat and 
electricity. 

The vegetable is a de-oxidizer. 

The vegetable is stationary. 



The animal consumes the non-ni- 
trogenized substances, sugar, starch, and 
gum. 

The animal produces carbonic acid, 
water, and ammoniacal salts. 

The animal absorbs oxygen. 

The animal produces heat and el- 
ectricity. 

The animal is an oxidizer. 

The animal is locomotive. 



We learn from the facts of Geology that the time was in the his- 
tory of our globe, when lunged animals could not breathe its atmos- 
phere ; it was too much loaded with carbonic acid. The trees then 
grew with a rapidity almost inconceivable, decomposing the poison- 
ous gas, taking to themselves the carbon and setting the oxygen free, 
and lifting up their brawny arms to heaven in acts of thankfulness 
for the great feast. 

At length the noxious gas was exhausted; and then, pale and sickly, 
they feebly held up their hands for help ; and God sent numberless 
tribes of warm-blooded animals, full of life and energy, that sported 
in the exhilarating air, and destroyed vast forests, thereby reproducing 
carbonic acid. 

These simple facts should teach man the sanitary importance of 
trees and bushes ; and wherever he has a rod, I had almost said a foot 
of ground to spare, a tree should be planted and carefully nursed. 
This is particularly necessary in large cities. Every narrow street 
even in Boston, should be lined with trees. For their absence, thou- 
sands of men, women, and children have died sooner than they other- 
wise would. We want them stretching up their arms to all our win- 
dows to give us oxygen, and to take to themselves the carbonic acid 
we exhale. 

Tight Dresses. — The health may be injured by not breathing air 
enough, as well as by inhaling that which is impure. It is therefore 
improper to compress the lungs by wearing tight dresses. If the ribs 
are held down by the dress, but little air can get into the lungs, and 
only a small amount of carbonic acid can be carried out. In this 
event, the health is injured in two ways ; the blood is not vitalized by 
oxygen received, and it is poisoned by carbonic acid retained. 



112 HYGIENE. 



Tight lacing has i)i a measure gone out of fashion ; yet too much 
of it for the best development of female health is yet retained. As a 
knowledge of physiology and the laws of life, and a better judgment 
of the true symmetry of the female form prevail, this barbarous cus- 
tom will pass out of use, and the substantial health, and real beauty 
of the American woman will together rise to a higher standard. 

Fill tlie lim^'S v/ell. — Persons who take but little exercise are apt 
to acquire the habit of drawing the air very little into the lower part 
of the lungs. This should be counteracted by taking long and full 
inspirations for a short time, every day, while in the open air. This 
practice would get the lungs in the habit of opening to the air quite 
down to their base, and would make the breathing much more natural 
as well as effectual at all times. In the case of young persons, it 
would enlarge the capacity of the chest, and add to the brief years 
of life. 

Travelling. 

It is true that many persons who dwell in one spot, and hardly 
move from it all their lives, live to old age. Yet change of location 
for a short time, or permanently, does promote health, and protract 
life. The mind tires of contemplating one set of objects for a great 
length of time ; and in the absence of all stimulation, it sinks into 
apathy, and imparts no energy to the body. The physical frame, 
partaking of the ennui of the mind, droops. This is doubly true when 
one is sutfering from illness. 

Travelling is eminently fitted to draw the thoughts of the nervous 
and feeble from themselves, and to turn them \vith interest to outward 
objects. This is of great importance. It is better than stimulants 
and tonics. 

The nervous system has great power over the health ; and the 
pleasurable sensations, excited by visiting new places and scenes, and 
conveyed to the mind through the nerves, often awaken in the consti- 
tution, energies which are essential to recovery. 

Travelling places a man in entirely new circumstances. It sur- 
rounds him w^ith novelties, every one of which makes a demand upon 
his attention. It breaks up his old trains of thought, which have been 
monotonous so long that they have grown oppressive. It causes the 
world, to touch him at a thousand new points, and surprises him every 
day, perhaps every hour, with a view of the false relations he has 
sustained to it. It opens to him new depths in his own nature, and 
causes him to wonder that they never attracted his attention before. 
It opens to him one door after another, leading him into new apart- 
ments of knowledge ; and as the world grows, he finds himself grow- 
ing with it, until his whole nature dilates and beats with new life. 

Means of Triivelliuir Increased. — The last twen»,y-five years have 
greatly increased the facilities for travelling. Many of the sick may 
now seek health in distant lands, who, had their circumstances been 



HYGIENE. 113 



similar twenty years ago, would have been compelled to pine at 
home. The cars give an easy jom-ney to thousands who could not 
have borne a ride in the old stage coach. 

One tliiii«' more wanted. — But one thing is wanted to bring the 
means of travelling, for the sick, very nearly to perfection ; it is a 
method of propelling carriages upon common roads, by some cheap 
power, which can never be exhausted, and which shall be easily man- 
aged by the traveller or his companion. This is a prominent want of 
the present hour ; \a giant discovery, which, at a single stride, would 
carry the world forward a hundred years, and which, we may hope, is 
in tlie womb of the near future. The power, it is believed, will be 
cledro-magnetism. The mode of applying it, when discovered, will 
be simple^ yet wonderful ; and the results to the sick, beneficent be- 
yond expression. The human mind cannot conceive the advantages 
which invalids would derive from such a mode of conveyance. Jour- 
neys might be long or short ; might be made with any rate of speed 
which tlie strength permitted. The morning or afternoon stages 
might be discontinued when fatigue demanded, and resumed at pleas- 
ure. Over uninviting regions the traveller might glide swiftly, and 
linger where nature spreads her feasts for the mind. 

The best Seasons for Travellin«' are spring and autumn. Winter 
is too cold. A pleasurable excursion may sometimes be made in 
summer ; but in general the season is too hot for comfort. In chang- 
ing climate, food, water, etc., in the sultry season, there is danger of 
contracting very troublesome bowel complaints. 

Means of Travellina: for the Poor, — There is one painful thought 
connected with travelling as a means of health. It cannot be en- 
joyed by the poor. When sick they generally have the careful 
attention of humane physicians ; they receive from kind neighbors 
little delicacies of food and drink ; they are watched with by night, 
and visited by day ; but though suffering from the hard routine of a 
laborious life, and needing diversion and recreation more than all 
else, they cannot travel. They have not the means, and nobody 
thinks of supplying them for such a purpose. 

This is a channel into which charity ought to pour some of its 
benevolent streams. In large cities there is a class of poor females, 
who sit in their small rooms and ply the needle diligently through 
the whole year, and who run down every summer very near to con- 
finement in bed. Two or three weeks, in the hot season, spent in 
travelling in the mountains and elsewhere, would bring back the color 
to the pale cheeks of such persons, and save them many years both 
from the grave and from the almshouse. No millionnaire could make 
a better use of his property than to set it apart, at his death, for the 
specific purpose of enabling the poor to travel. And if this sugges- 
tion should induce one rich man to consecrate his wealth to the God- 
like work of bestowing health, happiness, and intelligence upon the 
poor, the great labor of preparing this, book will not have been en- 
dured in vain. 

15 



114 HYGIENE. 



Amusements. 

That which engages the mind, and at the same time impresses it 
with pleasurable sensations, is a sufficiently accurate definition of 
amusement. Whatever occupies the thoughts and senses in an 
agreeable way, and employs them with some degree of intensity, 
comes under the same head. 

This broad and general definition allows us to regard our daily 
employments as amusements when they engage our deep attention, 
and at the same time give us pleasure. 

The term amusements, however, in the more popular sense, is re- 
stricted to those sports, games, plays, exhibitions, entertainments, etc., 
which involve a suspension of our daily labors, and are properly called 
diversions. 

When nature is tired and worn with those severe and exhausting 
toils by which we earn our bread, amusements turn us aside, divert 
us, engage other powers, and allow our tired faculties to rest. They 
are, therefore, of very gi'eat importance. Even the most trifling 
amusements may have the highest value. Their very nature and ob- 
ject imply that they will be valuable just in proportion as they divert 
and rest us. And just in proportion as they do these things, they 
give us health. 

One other thing amusements do for us, which must not be forgot- 
ten ; they preserve in us, in middle life, and even in old age, the warm 
simplicity of childhood. They keep us youngin our dispositions and 
feelings. They keep us in harmony with nature, and consequently 
artless and truthful. They prevent the formalities of conventional 
life from stiffening us into cold and repulsive hypocrites. 

Selection of Aimisemeiits, — Of course the same amusements are 
not adapted to all persons. The farmer who has worked his muscles 
all day, would not be benefited by a game of ball in the evening ; 
yet there are few games more suitable for the student who has bent 
for many hours over his books. Care should always be taken, there- 
fore, that amusements or sports do not bear upon those limbs or fac- 
ulties which are wearied by work. 

Amusements improve various faculties. — To one who has a taste 
for art ; who is fond of works of genius and poetry, theatrical enter- 
tainments w^ill always be agreeable, and a source of gratification and 
health. I know these exhibitions are objected to by many as immoral 
and hurtful, but more, I think, from habit and fashion, than upon any 
solid grounds of reason or religion. They certainly appeal to a high 
order of faculties in the human mind ; and to those who are fitted to 
receive them, teach lessons of great moment. Even the lower exhi- 
bitions of comedy, though not particularly improving to the mind, are 
yet, from their power to provoke laughter , among the most powerful 
up-builders of health. 

The Games of Whist, Euchre, etc., engage the minds of the players 
in a sort of mental contest, which is exciting, agreeable, and health- 



HYGIENE • 115 



imparting. These games make us skilful in calculating chances, and 
judijing how men ought to act under certain contingencies. They 
inake us sharp to detect and turn aside the unseen forces, which tend 
to oppose and destroy our success in life. 

I hardly need say that money or other property should never be 
staked upon a game of cards, or upon any other game. Gambling is 
one of the meanest as well as most destructive things in which men 
can eno^age. It raises the healthful excitement of these innocent 
amusements, — innocent when properly pursued, — into raging pas- 
sions, which, when defeat comes, as come it will, sink into remorse 
and bitterness as terrible as the mind can conceive. I warn young 
men as they would escape the pangs of a hell on earth, and the loss 
of character, happiness, and probably health for life, to avoid any 
such abuse of cards. 

Chess, Chequers, etc., appeal likewise to the fondness of competi- 
tion, which is common to all men. But they cultivate in us a little 
more of the mathematical element. As they require very close appli- 
cation of the mind, they are not suitable for persons of sedentary em- 
ployments, or whose daily avocations require a constant use of the 
I mind. Such persons should choose lighter and more active amuse- 
ments. 

Lig'hter Amusements. — Beside these higher amusements, there are 
a great number of lighter and more childish ones, which should not 
be overlooked. 

Some of these are merely physical, involving a trial of strength, 
fleetness, action, etc., as the games of ball, cricket, etc. Others are 
domestic in their nature, involving mirth, and various other of the 
lighter excitements, as blind-man's buff, puss in the corner, hole in the 
wall, fox and geese, hunt the slipper, hurly-burly, roll the platter, etc. 

In fashionable American households, these simple domestic plays 
have in a great measure, gone out of use, — being deemed vulgar, and 
below the dignity of ladies and gentlemen. I am sorry to say this ; 
for the vulgarity, in my judgment, is in those who reject them, and 
not in the plays. 

The officer of our navy, whose visit to the mansion of Lord Hard- 
wick I have spoken of on page 90, reports that on the evening of one 
of his visits, the play of blind-man's buff was engaged in by the 
whole party; and that his Lordship in attempting to ma'ke a short 
turn during the play, fell upon his back, when one of his daughters, 
who was blinded, caught him by the heels, and being assisted by 
others, drew him stern-foremost half the length of the hall, amid the 
shouts of the whole party. This would have been deemed very vul- 
gar by fashionable people in this country. But to me, who am no 
believer in any nobility which Lord Hardwick can receive from kings 
or queens, this simple narrative raised him at once to a peerage in 
nature's realm. Without doubt, he is one of nature's noblemen. A 
man in his station, and with his wealth and temptations to snobbery, 
who can preserve such simplicity of character, must have a warm as 
well as a noble heart in his breast. 



116 HYGIENE. 



Value of Domestic Ainiisements. — I remark here, that in all our 
amusements, we should as far as possible, seek those of a domestic 
character. They are more simple and childlike in their nature, and 
preserve in us, even to old age, the freshness of feeling, and truthful 
simplicity, which spread so beautiful a greenness over the autumn of 
life. 

Simple domestic amusements, too, are always gotten up on a cheap 
scale ; they do not encourage costly extravagance, and can be indulged 
in by the poor as well as the rich. 

But more, and better than all, they keep young men and old men, 
and young women and old women, at home, by making the domestic 
circle the centre of attraction. They draw the seekers of pleasure 
around the hearth-stone, instead of outward into the world. They 
incline young and old to look to the famihj circle as the centre of the 
most pure, because the most simple and natural, enjoyments. They 
teach us to look to home as the centre of life, and to all outside as 
only its appendages. 

It has been said that homes are found only in England ; that in 
other countries, life wanders, houseless and shelterless, abroad, seek- 
ing happiness, it knows not where, while in England it nestles warmly 
in the bosom of home. To whatever extent this is true, — and I be- 
lieve there is truth in it, — it is owing to the simple household amuse- 
ments of England. 

An American Want. — One of the great wants of this country is a 
more liberal provision for amusements. We attach here too much 
value to wealth ; and we pursue it with an intensity altogether in- 
compatible with health. We cannot take time for recreation because 
we are in so great a hurry to be rich. 

If we would save ourselves from a total wreck of health, we must 
take broader and better views of life. We must value it for its solid 
comforts, rather than for its glitter and show. 

We need quite an increase in the number of our holidays, — days 
on which thp people can give themselves up to sportive recreations. 
Some progress has been made in this direction of late. Washing- 
ton's birth day has very nearly fixed itself among us as a holiday ; 
the claim of Lafayette's to a similar observance is beginning to be 
acknowledged. Quite a number more, scattered through the year, 
are much wanted. They would save hundreds of our population 
annually from insanity. 

Contrary to the general belief, insanity is very prevalent among 
seamen and farmers. The former lead a life of dreary solitude upon 
the ocean ; the latter, one, if not of equal, certainly of very objection- 
able solitude upon the land. The sailor who does business upon the 
great sea, should provide himself with great numbers of games to 



amuse hi«i in his wanderings. The farmers of our land should culti- 
vate more of the sociabilities of life. Let them meet tos^ether in the 
fine summer evenings, like the peasants of France, and dance gayly 
upon the green lawns before their cottages. They will till their lands 
more cheerfully for it ; enjoy better spirits and health ; and live to 
greater age. 



HYGIENE. 117 



Compieteiiess of Life. — Amusements are necessary in order to give 
a completeness to life. The faculties of the human mind are numer- 
ous. It is only \vhen they are all exercised, in their due proportion, 
that there is a harmonious beauty in our lives. The customs of soci- 
ety twist us all out of shape, — perverting us mentally, morally, and 
physically, and robbing us of every manly and healthful quality. 
Getting out of the ruts of fashionable life, we must come back to the 
simple paths of nature. 



TEMPERAMENTS, CO:XSTITUTION, AND SYMPTOMS. 



Man has thinkings ivarming^ nourishing^ and moving powers. For 
the performance of each of these great functions, he has organs of 
the best possible construction. 

For Tlimkmo', he has a brain. If this be large in proportion to his 
other organs^ it gives a character, a cast, a peculiarity to his whole 
organization. Everything about him is subordinate to his brain. 
We recognize him, at once, as a thinking and a feeling being. He 
has an intellectual look. There is a delicacy, a refinement, a sensi- 
tiveness, a studious habit, an air of thoughtfulness about him, which 
determine his traits, his tone, his temper, his whole character. Hence 
it is proper to say he has a cephalic or thinking temperament. 

The Limo's aud Heart, devoted to renewing and circulating the 
blood, are placed in the chest or thorax. 'If these be large in man in 
proportion to other organs^ he is characterized by great activity of cir- 
culation, by a large supply of red blood, and by the general indica- 
tions of a full, warm, and bounding life. This activity gives him his 
tone and temper, and shows that his is the thoracic or calorific temper- 
ament. 

lu the Great Cavity of the Abdomen is done the work of receiving, 
digesting, and disposing of the materials which nourish the body. 
If the organs which do this work be large in proportion to others^ the 
body is fed to repletion, and the whole organization speaks of the 
table. The habit, the look, the temper, are all sluggish. This is the 
abdominal or alimentary temperament. 

The Bones and Muscles are instruments by which the movements 
of the body are performed. If these be the largest, in proportion, of 
any in the body, then the locomotive powers are in higher perfection 
than any others. There is largeness of person, energy of movement, 
and greatness of endurance. The whole cast of the person partakes 
of the strength and coarseness of bone and muscle. This is the mus- 
cular or locomotive temperament. 

This gives as four temperaments, as follows : 

I. The Cephalic Temperament, denoted by large brain, activity of 
mind, and general delicacy of organization. 



TEMPERAMENTS, COXSTITUTIOX, AND SYMPTOMS. 119 

IT. The Thoracic Teinperainent, indicated by a large chest, force 
of circulation, rednej?s of skin, great activity, warmth of temper, and 
fuhiess of life. 

III. The Abdominal Teinperainent, denoted by a large develop- 
ment of the stomach, liver, bowels, and lymphatics ; by a fulness of 
belly, fondness of high living, and a disposition to float sluggishly 
U})on the current of the world, rather than to struggle against it. 

IV. The ^Inscnlar Tempera ment, indicated by largeness of frame 
and limbs, coarseness of structure, and great power of locomotion 
and endurance. 

There are some reasons for reckoning but three temperaments in- 
stead of four, by reducing the thoracic and abdominal to one, after 
the manner of the phrenological Fowlers, — especially as the organs 
in the chest, and their appendages, take an important part in the pro- 
cess of nutrition. But as the heart and lungs are placed in one cavity, 
and the stomach, liver, etc., in another; and as one set of these organs 
luay be largely developed, and the other defectively, I have thought it 
most convenient, on the whole, and quite as philosophical, to retain 
the four temperaments. 

These temperaments seldom or never appear single and pure. They 
mix and cross with each other in all possible ways. 

Medication and Temperaments. 

The object of speaking of temperaments in this work, is to make 
the reader acquainted with the principles upon which remedies are to 
be adapted to their development. The philosophical-minded physi- 
cian will, in prescribing, always keep the temperament in view. 

Persons of a Cephalic Temperament cannot bear powerful medi- 
cines, — particularly drastic purges. Their fine, delicate and sensitive 
organizations would be torn all to pieces by doses which would hardly 
be sufficient in a fully-developed muscular temperament. This should 
always be borne in mind in prescribing for persons of a large brain 
and delicate organization. 

In this temperament, too, fevers, instead of running a high and 
fiery course, take the low typhoid type, the patient becoming pale, 
and showing a constant tendency to sink. Such patients would be 
killed by purging, leeching, cupping, sweating, and starving. They 
want tonics, stimulants, and every kind of support which the case 
will possibly permit. 

Persons of a Tlioracic Temperament, having a rapid circulation, and 
a fulness of blood, are most liable to inflammatory diseases. When 
fever attacks them, they have what is called a " high fever." If rheu- 
matism comes, it is acvte rheumatism. Disease takes hold of them 
smartly. As they do everything with emphasis and energy when well, 
so, when ill, they make a business of it, and are sick with all their 
might. 



120 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 

Stimulants and tonics generally make such persons worse. They 
want sedatives, and diaphoretics, and sweats, and purgatives, and 
leeches, and cups, and low diet, and cold bathing, and whatever else 
will slacken the ferocious swiftness of their circulation. 

Those of the Abdominal Temperament are not particularly subject 
either to very high fevers, or to those typhoid forms which produce 
sinking. As in the two temperaments noticed above, their com- 
plaints chiefly attack the organs most largely developed. Their dis- 
eases affect the stomach, the liver, the spleen, and the bowels. These 
are the largest organs in their bodies, and are most used ; and, being 
overworked, they fall into disease. 

As these persons are slothful in all their habits, so their diseases 
run a sluggish course. They are not so liable to sudden death as 
persons of either of the preceding temperaments. They have all 
sorts of chronic diseases which linger a great while, and are cured 
with much difficulty. 

These persons will bear larger doses of medicine than either of 
the preceding. Neither do their constitutions respond as readily to 
medicine. A physician will be disappointed if he expects to see 
them recovering as fast under its use. 

Those of a Muscular Tem})erament, having little fondness for any- 
thing but a hardy, active life, are much exposed to the elements. 
Though strong and long-enduring, the hardship of their lives often 
breaks them down, and when felled by disease, they are oftentimes 
shockingly racked and torn by it. 

These persons bear large doses of medicine, and when sick, need 
to be treated with an energy proportioned to the strength of their 
constitution. Rheumatism, which affects the joints, the ligaments, 
and the tendons, is an affection from which they suffer severely. 

The Constitution. 

In prescribing for disease, it is of very great importance to take 
notice of the constitution. This is a different matter from the tem- 
peraments. Persons of the same temperament are often quite unlike 
in the strength of their constitution. And those having good natural 
constitutions, frequently abuse them by improper habits and indul- 
gences, and at length come to have broken and very feeble constitu- 
tions. 

Some persons' muscles and other tissues are put together as if they 
were intended never to come apart. Like some of the woods of the 
forest, — the lignum vitae for example, — they are fine-grained and 
tough. A real smart boy will wear out an iron rocking-horse sooner 
than one of these persons can exhaust their constitution by hard work. 
Others, to outward appearance equally well made, have very little 
endurance, break down easily under hard work, and lose their flesh 
from trifling causes. 

The state of the constitution, therefore, should always be learned 
before much medicine is given ; for what a person of a strong consti- 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 121 

tution will rieed^ may greatly injure a feeble person, even of the same 
temperament. 

Habits. — These must likewise be attended to. Persons using 
stimulants require larger doses of medicine to affect them than other 
persons. 

Cluiiilte. — Medicines act differently on the same persons in sum- 
mer and winter. Narcotics act more powerfully in hot weather and 
climates than in cold, and must be given in smaller doses. 

Idios;nierasy. — Medicines of only ordinary activity, act very power- 
fully, and even violently on some persons. This is owing to a pecu- 
liarity of stomach, or constitution, called idiosyncrasy. It makes the 
person, in this particular, an exception to the general rule. And no 
physician can know beforehand in what particulars this exceptional 
disposition will show itself Persons, however, learn their own idio- 
syncrasies, and should make them known to those who prescribe for 
them for the first time. 

The Se\. — The peculiarities of each sex should never be forgotten 
in prescribing for the sick. 

Males are not so sensitive as females. They will bear more medi- 
cine, and their nervous system is not so readily excited by it. 

Iiifliieiioe of A^e. — Human life is divided into infancy, childhood^ 
yoidh^ manhood., and old age. Each of these periods has peculiarities 
which modify disease. 

Tlie First Period, extending from birth to the age of seven years, 
is marked by tenderness and excitability, and is alive to every irrita- 
tion. Teething and other disturbances occur at this period, and need 
careful management. 

Tlie Second Period extends from seven to fourteen, and is quite 
subject to disease, including the second dentition. During these two 
periods, there is no great difference between the sexes ; both are ten- 
der, and need careful watching. 

Diu'iii^ the Third Period, the changes occur which mark and sepa- 
rate the sexes. This is a developing period, when the functions 
become established, and the frame acquires form, proportion, and 
strength. 

At this time, hereditary tendencies to disease, latent till now, begin 
to show themselves, and call for every possible endeavor to break them 
up, and fortify the constitution. 

The Fourth Period embraces the vigorous maturity of life, when 
the powers of body and mind, in both sexes, are at \he summit of 
their excellence. The functions are now well established. It is dur- 
ing this period that the female is subject to most of the harassing 
ailments peculiar to her sex. So numerous are these complaints, and 
so large and valued the class of persons affected by them, that he who 
treats them with the greatest skill, and with the delicacy which their 
nature demands, may be said to be at the head of his profession. 

16 



122 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



The Fifth Period is that of old age, when the functions are declin- 
ing, and the frame is bending under the weight of years. Old age 
begins earlier with females than with males. Many ailments are 
common to this period, which require peculiar management, both 
medicinal and hygienic. 

Proper Frequency of Dose. — Each succeeding dose should be given 
before the eft'ect of the preceding is gone. If this rule is not attended 
to, the cure does not advance. What is gained by each dose is lost 
by the rallying of the disease in the interval. Care must be taken, 
however, not to apply this rule too strictly with very active medicines. 

How to Examine a Patient. 

When a patient is presented for examination, having observed the 
temperament, constitution, sex, and age, 

1. Learn the causes of the disease, whether local, specific, or gen- 
eral, and also its history. 

2. Search out its nature and character, whether febrile or other- 
wise. 

3. Take notice of the whole train of symptoms, — embracing the 
pulse, the condition of the mouth, tongue, and digestive organs, the 
breathing, the urine, the fecal discharges, the condition of the brain 
and nervous system, the state of the skin, etc. 



Brief Table Explanatory of Symptoms, 



GExMERAL APPEARANCE OF PATIENT. 



1. Tonic Spasm of the trunk. 

2. Distorted features, altered position, 
and impaired motion of limbs. 

3. Irregular and pei'petual motion. 

4. Entire and absolute immobility. 

5. Great and unnatural boldness. 

6. Great and unusual languor. 

7. Ability to lie only upon the back. 



8. Lying upon the face. 

9. Lying upon one side. 



10. Maintaining the sitting posture only. 

11. The head thrown back. 

12. Restlessness and tossings. 

13. General enlargement of bod}-. 



1. Locked jaws. 

2. Paralysis of one side. 

3. St. Vitus's dance. 

4. Catalepsy. 

5. Insanity or delirium. 

6. The beginning of an acute disease, 
or the progress of a chronic one. 

7. Apoplexy. Organic disease of the 
brain or spinal marrow. Acute Inflamma- 
tion of the lining of the abdomen. Rheu- 
matism of the joints. 

8. Several kinds of choHcs. 

9. Pleurisy, or Inflammation of the lungs. 
When one King only Is affected In con- 
sumption, the patient generally lies on the 
diseased side. 

10. Disease of the heart or lungs, which 
Interferes with breathing. 

11. Severe diseases of the larynx and 
windpipe. 

12. The beginning of acute Inflamma- 
tion. Fevers. Delirium, and acute mania. 

13. Cell-dropsy. Emphysema from a 
wound of the chest. 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 123 


Head, Face, and Neck. 


1. Head bent to one side. 


1. Convulsions. Paralysis of one-half 


j 


the body. Dislocation of bones of neck. 




Swelling of glands of neck. 

2. Chronic hydropholus. Enlarged 


I 2. Head increased in size. 


1 


brain. 


3. Swollen scalp. 


3. Erysipelas. Small pox. 


1 4. Dull expression of face. 


4. Typhoid fever. 


' 5, Full, red lace, with blood vessels of 


5. Swelling of heart. Congestion of 


j eyes injected. 


brain. 


1 ' 6. Pinched, contracted countenance. 


6, Acute inflammation of peritoneum. 




Exposure to severe cold. 


7. Pinched nose, sunken eyes, hollow 


7. Chronic disease just before death. 


: temples, skin of forehead tense and dry, 




: complexion livid. 




8. Wrinkles across the forehead. 


8. Excessive pain arising externally. 


9. AVrinkles from forehead, vertically, 


9. Distress, anxiety, and severe inter- 


to root of nose. 


nal pain. 


10. A white line from inner angle of 


10. In children, a brain or nervous af- 


the eye to just below the cheek bone. 


fection ; in adults, abuse of the generative 




organs. 


11. "White line from the upper border 


11. In consumption and wasting of flesh. 


of the wing of the nose (ala nasi), curved 


The lower part of the line indicates dis- 


i to the outer margin of the orb of the eye. 


ease of stomach; the upper part, some affec- 


1 


tion of upper part of bowel. When united 


1 


with the white line named above, and with 


1 


a drawing in of the cheek, fixed eyes, and 


j 


a wan complexion, it implies worms. 


' 12. The white line in children from an- 


12. An affection of the chest, with diffi- 


gle of mouth to lower part of face. 


culty of breathing. 


13. A white line external to the last 


13. Chronic and obstinate disease in the 


two, in a semicircular direction towards the 
1 chin. 

14. Swelling of face and eyelids. 


chest or belly. 


14. Albumen in the urine. 


i 1.5. Transient redness or flushing of face. 


15. Suffering from the monthly irregu- 


1 


larity. 


16. Hectic flush. 


16. Consumption. Chronic affections. 


1 7. Paleness of face. 


1 7. Cold stage of fever. Acute inflam- 




mation. Chronic diseases, especially 




Bright's disease, during recovery. 


■ 18. Dingy, white, or greenish face. 


18. A low and deficient state of blood. 


19. Yelio'w tint. 


19. Jaundice. 


20. A citron tint. 


20. Cancerous disease. 


21. A bluish tint. 


21. Poor circulation in the veins. Chol- 


* 


era. Typhus fever. Blue disease. 


22. Perpetual motion of eyelids. 


22. Mania and idiocy. 


23. Forcible closure of eyelids. 


23. Intolerance or dread of light. 


24. Eyelids remaining open. 


24. Orbicularis palpebrarum. Paralysis 




of the muscle which closes the eye. 


1 25. Palsy of the upper lid. 


25. Injury of the third pair of nerves. 


26. Flowing of tears over the cheek. 


26. Obstruction of the lachrymal duct. j 


27. Nostrils dilating forcibly and rapidly. 


27. Difficulty of breathing. 


i 28. Itching of nostrils in children. 


28. Worms in the bowels. 


' The Tongue. 


1. Surface of tongue covered with a 


1. Derangement of stomach, or bowels. 


layer of whitish, soft, mucous substance, 


or both. 


i which may partially be taken off with a 




scraper, — also, clammy mouth. 

! 


1 



124 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



2. State of tongue as above, with clammy 
mouth, bitter taste, and fetid breath. 

3. Great load on tongue as above, which 
peels off^ leaving the tongue smooth, red, 
and tender. 

4. Tongue slightly white from small white 
points, and sometimes covered with fur, 
like the fibres of coarse velvet. 

5. Tongue pale, tumid, clean, and very 
smooth. 

6. Ton^Q furred sjidi dry. 

7. Tongue white and loaded, with much 
thirst. 

8. As above at first, — afterwards clean, 
red, and dry. 

9. Tongue white and loaded, with dry- 
ness. 

10. Tongue dry, parched, tender, and 
dark brown or black. Pushed out with 
great difficulty and trembling. 

11. Tongue loaded with white, through 
which numerous elongated, very red pap- 
illa protrude their points. 



2. Acute dyspepsia. Asthma. 

3. Severe cases of acute dyspepsia. 

4. Chronic dyspepsia. Some affection 
of the liver, if the fur be yellow. 

5. Chlorosis or green sickness. 

6. Violent local inflammation. Irrita- 
tion in bowels. 

7. Inflammatory fever. 

8. Protracted inflammatory fever. 

9. IVIild typhus fever. 

10. Severer forms of typhus fever. 

11. Scarlet fever. 



The Throat. 



1. Throat enlarged. 

2. Violent pulsation of carotid arteries. 



3. Pulsation of the nameless artery 
(arteria innominata) above the breast 
bone, and to the right of the windpipe. 

4. Circumscribed swelling about throat. 



1. The approach of puberty In females. 

2. Acute mania. Inflammation of brain. 
Enlargement of heart, and dilation of right 
ventricle. Anemia. 

3. Ee^ursitation from aorta. 



4. Enlargement of glands. 



1. General enlargement of one side of 
chest. 

2. Bulging at the base of a lung. 

3. Bulging at front upper part of chest. 

4. Bulging right hypochondrium (See 
Fig. 95). 

5. Bulging in region of heart. 

6. Tumor where the third rib joins the 
breast bone. 

7. Tumor between the base of the shoul- 
der blade and the spine. 

8. Depression or retraction of one side 
of chest. 

9. Breathing Increased in rapidity. Gen- 
erally, in health, about twenty breaths are 
taken in a minute. 

10. Breathing diminished in rapidity. 



The Chest. 

1. Large effusion of water from pleurisy. 



2. Water from pleurisy settling to the 
bottom. 

3. Emphysema. 

4. Enlargement of liver. 

5. Water in heart-case. Enlargement 
of heart. 

6. Aneurism of the ascending aorta. 

7. Aneurism of the descending aorta. 

8. Consumption. Absorption of fluid, 
effused by pleurisy. 

9. Spasmodic asthma. 



10. Pleurisy. Paralysis of respiratory 
muscles. Inflammation of lungs. Emphy- 
sema. Pneumothorax. Consumption. 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 



125 



11. Jerking respiration. 

12. Breathing with muscles of ribs only 



11. Spasmodic asthma 
larynx and windpipe. 

12. Abdominal inflammation, 
mation of diaphragm. 



Obstruction in 
Inllam- 



The Belly. 



1. Increased size of bellv 



2. Enlargement in epigastrium. Fig. 93. 

3. Enlargement in hypogastrium. Fig. 95, 

4. Belly diminished in size. 



1. Dropsy. Wind in bowels. Inflam- 
mation of peritoneum. Obstruction in 
bowels. Hysteria. 

2. Hysteria. Cancer of stomach. 

3. Distension of bladder. Ovarian tu- 
mors. Accumulation of feces in bowels. 

4. Chronic dysentery. Lead colic. Also 
in most chronic diseases. 



Private Organs, 



1. Enlarged penis in children. 




1. Stone in bladder. Masturbation. 


2. Drawing up of testicles. 




2. Stone in kidneys. 


3. Enlargement of scrotum. 




3. Hydrocele. Hematocele. Sarcocele. 




The I 


jimbs. 


1. The limbs immovable. 




1. Paralysis. 


2. Limbs contracted and rigid. 




2. Softening of the brain. 


3. General swelHng of limbs. 




3. Defective circulation of blood. 


4. Swelling of joints. 




4. Rheumatism. Water in the joints. 
White swelling. 


5. Limbs diminished in size. 




5. Paralysis. 


The 


Nervo 


US System. 


1. Morbidly increased sensation. 


1. Acute inflammation of brain and 






spinal marrow. Fevers. Hysteria. 


2. Tensive pain. 




2. Phlegmonous inflammation. 


3. Dull, heavy pain. 




3. Enlarged internal organs. Internal 
tumor. Eff^usion of water into cavities 
lined with serous membranes. Felt in the 
loins previous to discharge from menstrua- 
tion, and from piles. 


4. Smarting pain. 




4. Scarf skin removed. 


5. Shooting, tearing pains. 


• 


5. Neuralgia. Cancer. 


6. Boring pains. 




6. Constitutional syphilis. Rheumatism. 
Gout. Inflammation of periosteum. 


7. Contusive pains. 




7. Bruises. Acute diseases. 


8. Itching. Sensation as of ants creep- 


8. Several diseases of the skin. 


i ing over the skin. 






9. Exaltation of vision. 




9. Ophthalmia. Inflammation of brain. 
Some nervous diseases. 


10. Black flecks floating before the eyes. 


10. Affections of the brain and optic 






nerve. Dyspepsia. 


11. Painfully acujte hearing. 




11. Inflammation of brain. Hysteria. 


12. Dull hearing. 




1 2. Typhus fever. 


13. Increase of strength. 




13. Delirium. Inflammation of brain. 
Mania. 


14. Debility. 




14. Most diseases. 



126 TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 


15. Trembling. 


15. Cold stage of fever. Nervous affec- 


^ 


tions. Old age. Action on the system of 




lead, mercury, strong coffee, alcoholic 




drink, tobacco, opium. 


16. Rigidity of upper extremities. 


16. Softening of the brain. Infiltration 


17. Cramp. 


of blood into the brain. Hysteria. 


17. Pregnancy. Hysteria. Painters' 
colic. 

18. In convulsions of children. Some 


18- Temporary spasm. 




afi'ections of the brain. 


19. Pain at extremity of penis. 


19. Stone in bladder. 


20. Pain in right shoulder. 


20. Congestion of liver. 


21. Pain in left shoulder. 


21. Disordered stomach. 


£2. Exaltation of affections. 


22. Hypochondriasis. 


23. Loss of moral sensibility. 


23. Mania. Typhus fever. Masturba- 




tion. 


24. Exaltation of intellect. 


24. Melancholy. Sometimes indicates 




close of life. 


The Breathing. 


1. Stiffness of chest. 


1. Cartilages turned to bone. Pleura 




hardened. Distortion from rickets. 


2. Pressure upon parts. 


2. Tumors. Dropsy of belly. 


3. Obstruction of air-tubes. 


3. Spasm of glottis. Spasm near the 




small ends of bronchial tubes. Mucus, 




etc., thrown out upon the inner surface. 


4. Compression of lungs. 


4. Effusions in pleurisy. Water in 




chest. Air in substance of lungs. Aneu- 




rism and other tumors. 


5. Pain in parts moved in breathing. 


5. Pleurisy. Inflammation of perito- 




neum. 


6. Paralysis of muscles of chest. 


6. Injury of spinal marrow. 


7. Spasm of muscles of chest. 


7. Locked jaw. Spasmodic asthma. 


8. Deficiency of red blood. 


8. Anaemia. Chlorosis or green sickness. 


The C 


ough. 


1. Hollow and barking cough. 


1. Last stage of consumption.^ Chronic 




bronchitis. Some nervous affections. 


2. Sharp, ringing cough. 


2. Croup. 


3. Hoarse cough. 


3. Beginning of cold. Chronic laryngitis. 


4. Wheezing cough. 


4. Asthma. 


5. Belching cough. 


5. Some diseases of larynx. 


6. Cough in paroxysms. 


fi. Hooping cough. Hysteria. 


7. Cough sounding harsh and concen- 


7. Consumption. Inflammation of the 


trated when hstening with the stethoscope. 


lungs. Pleurisy. Enlargement of bron- 




chial tubes. 


8. Cough sounding hollow, when listen- 


8. Tuberculous cavity. Enlarged bron- 


ing with the stethoscope, as though it came 


chial tubes. 


from a cavern. 




9. Cough having a metalic or ringing 


9. Large tuberculous cavity. 


sound when listening with the stethoscope. 




The Expe 


ctoration. 


1. Scanty expectoration. 


1. First stage of acute diseases of the 


2. Copious expectoration. 


lungs. 

2. Decline of acute diseases of air pas- 




sages and lungs. 



TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS. 127 


3. Waterv expectoration. 


3. Beginning of bronchitis. Conges- 
tion of lungs. Vesicular emphysema. 


' 


4. Mucous expectoration. 


4. Bronchitis. Infiammatiou of lungs. 


5. Expectoration of pus. 


5. Consumption. Third stage of in- 




flammation of lungs. 


G. Expectorated matter shaped like 


6. Tubercular consumption. Bronchi- 


coin (nummular). 


tis of measles. 


7. Muco-purulent, floculent expectora- 
tion. 

8. Tubular expectoration. 


7. Consumption far advanced. 


8. Plastic bronchitis. Pneumonia. 


9. Whitish or greenish expectoration, 


9. Acute aff'ections of lungs, particu- 


that clings to the vessel. 


larly bronchitis. 


10. Yellow expectoration. 


10. Chronic bronchitis. Other chronic 




affections of the lungs and throat. 


11. Rusty expectoration. 


11. Inflammation of the lungs. 


1 2. Putrid smell of expectoration. 


12. Gangrene of the lungs. 


13. Faint and sweetish smell of expec- 


13. Bronchitis. First stage of consump- 


toration. 


tion. 


U. Expectoration smeUing like garlics. 


14. Broncho-pleural fistula. 


Pain. 


1. Dull, heav}', aching pain at the base 


1. Acute bronchitis. 


of the chest. 




2. Soreness about the breast bone, and 


2. Acute bronchitis. 


between the shoulders. 




3. Sharp, sudden, tearing pain below 


3. Pleurisy. 


the nipple. 




4. Pain darting from front part of chest 


4. Consumption. 


to between shoulder blades. 




5. Constant pain between the shoulders. 


^. Consumption. Greensickness. Other 




chronic diseases. 


The Pulse. 


1. Strong pulse, resisting compression 


1. Inflammatory affections, especially 


by the finger. 


of the substance of large organs, as the 




liver, etc. 


2. Weak pulse, easily pressed down. 


2. Prostration from disease. Nervous 




and chronic affections. Fear. Diseases 




of women and children, and old persons. 


3. Full pulse, as if the artery were in- 


3. Congestion of brain. Apoplexy. 


creased in size. 


Disease of heart. 


4 Small pulse, opposite of full. 


4. Inflammations of stomach, bowels, 




bladder, etc. Hysteria, and other nervous 




affections. 


5. Hard, sharp, contracted pulse, — vi- 


5. Inflammation of membranes. Active 


brating like a cord under the finger. 


bleedings. Lead colic, etc. 


6. Soft pulse, yielding readily to pres- 
sure. 

7. Frequent pulse. 


6. Affections characterized by debility. 


7. Inflammatory diseases. Hemorrhages. 


8. Slow pulse. 


8. Apoplexy. Sometimes in disease of 




heart. 


Relating to Digestion. 


! 1. Tongue trembling and dry, and di- 


1. Typhoid and other low fevers. 


minished in size. 




2. Voracious appetite. 


2. Pregnancy. Hysteria. Insanity. 




Sometimes in dyspepsia. 



128 tempeka:mexts, constitution, and symptoms. 


3. Diminished appetite. 


3. In most acute diseases. 


4. Increased thirst. 


4. Acute affections of stomach and 




bowels. 


5. Thirst ^one. 


5. Cerebral disease, with coma. 


1 6. Vomiting. 


6. Early pregnancy. Colic. Disease of 




brain. Inflammation of stomach. Hernia. 


7. Pain increased by pressure. 


7. Inflammation of internal organs. 


8. Pain relieved by pressure. 


8. Over-distention of bowels. Neural- 




gia. Colic. 


i 9. Urgent desire to go to stool. 


9. Dysentery. Sometimes in diarrhoea. 


10. Watery stools. 


10. Diarrhoea. Cholera. 


11. Mucous stools, like white of egg. 


11. Chronic inflammation of colon. 


12. Hard and lumpy stools. 


12. Constipation. Colic. Cancer of 




stomach. 


13. Clay-colored stools. 


13. Deficiency of bile. 


14. Yellow or dark-brown stools. 


14. Too much bile. 


15. Dark-green stools. 


15. Bile from children after taking cal- 
omel. 

16. Dysentery. 


i 

! 16. Stools red, and streaked with blood. 


1 1 7. Pitchy black stools. 


17. Melaena. 


18. Stools pure blood, with no colic. 


18. Bleeding piles. 


1 19. Stools like rice-water. 


19. Asiatic cholera. 


20. Black stools. 


20. Iron taken in medicine. 


21. Shreds of false membrane in stools. 


21. Dysentery. Diarrhoea. Worms. 


22. Fat with stools. 


22. Diabetes. Consumption. 


23. Fetid stools. 


23. Diseases attended by debility. 


The Urine. 


1 Diminished secretion of urine. 


1. Dropsy. Inflammatory and febrile 




diseases. 


2. Retention of urine in the bladder. 


2. Paralysis. Typhoid fever. Hysteria. 


3. Urine increased in amount. 


3. Diabetes. Cold stage of fevers. 


1 


Hysteria. Various passions of the mind. 


, 4. Red or yellow sand deposits in urine 


4. Fevers. Acute rheumatism. Con- 


(uric acid). 


sumption. Dyspepsia. Great indulgence 




in animal food. 1 


5. White sediment in urine (earthy 


5. Depressed state of the nervous sys- 


i . phosphates). 


tem, of serious import. - j 


6. Oxalate of lime deposits in urine. 


6. Derangement of digestion. | 


7. Blood in urine. 


7. Bleeding of kidneys, etc. 


! 8. Albumen in urine. 


8. B right's disease. 


9. Mucus in urine. 


9. Inflamed mucous membrane of ure- 




thra, bladder, etc. 


10. Sugar in urine. 


10. Diabetes. 


The Pers 


piration. 


1. Profuse perspiration. 


1. Acute rheumatism. Decline of acute 




inflammations and fevers, being sometimes 




critical. 


2. Diminished perspiration. 


2. Early stage of acute disease. Dropsy. 




Diabetes. 


1 3. Kight sweats. 


3. Consumption. 


1 4. Sour smelHng sweats. 


4. Rheumatism. Gout. 


1 5. Fetid smelling sweat. 


5. Some debilitating fevers. 


6. Sweat with mouldy odor. 


6. INIeasles. Scarlet fever. 


j 7. Smelling like ammonia. 


7. Typhoid fever sometimes. 


8. Sweat having the odor of mice. 


8. Insanity. 


9. Sweat smelling like rotten-stone. 


9. Mliary. 



TEMPERAMEXTS, CONSTITUTION, AND SYJ^IPTOMS. 



129 



The Temperature. 



1. General heat of surface. 

2. External local heat. 

3. Hot forehead. 

4. Hot scalp. 

5. Skin of chest hot. 

6. Hands and feet hot. 

7. Ac 
applied. 

8. Chills. 

9. Low temperature. 
10. Cold hands and feet. 



1. Fevers. 

2. Inflammation. 

3. Headache. 

4. Disease of brain. 

5. Inflammation in chest. 

6. Consumption. 

7. Typhus fever. 

8. Beoinnino; of fever. 

9. Poor circulation. 

10. Nervous diseases. Dyspepsia, 

state of the blood. 



Low 



17 



SKIN DISEASES 



The skin is the soft and pliant membrane which covers the entire 
surface of the body. The interior, like the exterior, is likewise covered 
by a skin, which, from its always being moist, is called a mucous 
membrane. At the various openings of the body, the outer and the 
inner skins are united, — forming one continuous skin, — like the 
same piece of silk turned over the border, and covering both the out- 
side and inside of a bonnet. 

From this continuity or oneness of the skin and mucous membrane, 
springs an important medical law, namely, that a disease of the skin 
may spread to the mucous membrane, and a disease of the mucous 
membrane may spread to the skin. "We see this illustrated by the 
breaking out around the lips which follows colds, and the itching of 
the nose of children when the mucous membrane of the bowel is irri- 
tated by worms. 

TJie Skin is Composed of Two Layers. — These are separated from 
each other by the action of a blister. The thin portion which is 
raised up by. the fluid of a blister is called the scarf skin^ the cuticle^ 
or the epidermis ; that which remains in connection with the body is 
the sensitive skin, the cutis, the derma, or the true skin. The two 
skins have very different offices to perform. The scarf-skin is horny 
and insensible, and serves as a sheath to protect the more sensitive 
skin under it. Were the scarf-skin taken off, we could not bear to 
have anything touch us. 

The derma, or true skin, and its glands, etc., are the seat of all the 
cutaneous diseases. These may be separated into four great divis- 
ions, — namely, diseases of the true skin, diseases of the sweat glands 
and tubes, diseases of the oil glands and tubes, and diseases of the 
hairs and hair glands. 

Then the diseases of the true skin are divided into 

Inflammation of the true skin ; 

Enlargement of the papillce of the true skin ; 

Disorders of the vessels of the true skin ; 

Disorders of the sensibility of the true skin ; 

Disorders of the color-producing function of the true skin. 

The inflammation of the true skin is conveniently divided into two 
groups, — namely, 



Ph 





> 











C/3 




-^^^F 












SKIN DISEASES. 131 



Such as are marked by inflammation of the derma and mucous 
membranes, xcith constitutional symptoms of a specific kindy and 

Such as are distinguished by inflammation of the derma, without 
constitutional symptoms of a specific kind. 

Congestive Ii^flammation of the True Skin. 

The First of these Groups, — those characterized by inflammation 
of the cutis, with constitutional symptoms of a specific kind^ — embraces 
measles^ scarlet fever^ varioloid^ small-pox^ and coiv-pox. 

Measles. — Rubeola, 

Measles is an acute inflammation of the entire skin, both external 
and internal, associated with an infectious and contagious fever. 

Symptoms. — The disease sets in with chills, succeeded by burning 
heat, listlessness, languor, drowsiness ; pains in the head, back, and 
limbs ; frequent pulse ; soreness of the throat ; thirst, nausea, vomit- 
ing, frequent dry cough and high-colored urine. These symptoms 
increase in violence for four days. On the third day the eyes become 
inflamed, cannot bear the light, and pour 'fourth a profusion of tears. 
This last symptom is called coryza. The nose likewise discharges a 
large quantity of watery secretion, and sneezing is frequent. The 
larynx, windpipe, and bronchial tubes become inflamed, and hoarse- 
ness, soreness of the breast, etc., are the result. 

The redness of the skin and breaking out appear about the fourth 
day, and produce heat and itching. This breaking out is character- 
ized by a patchy redness, which, on close inspection, is found to consist 
of numberless minute red points and pimples, collected into patches 
in the shape of a half or quarter moon. They appear first on the 
forehead and front of the neck, then upon the cheeks and around the 
nose and mouth. On the fifth day they reach their height in this 
region, and then appear upon the body and arms, and on the sixth 
day, upon the legs. The color of the skin wheji the inflammation is 
at its height, is of a bright raspberry red. The decline of the rash 
takes place in the same order in which it comes out. The redness 
fades on the sixth day upon the face ; on the seventh, upon the body 
and limbs ; on the eighth, upon the backs of the hands. The coryza, 
the hoarseness, and the cough, decline about the seventh day, while a 
diarrhoea comes on about the eighth or tenth, — showing that the in- 
flammation of the mucous membrane is subsiding. When the in- 
flammation disappears, the whole scarf-skin peels off in the form of a 
scaly scurf. The artist has given a good picture of the disease in the 
beautifully colored lithograph, Plate I, Fig. 1. This plate is admi- 
rably done. 

Treatment. — When the disease is mild and regular in its course, 
scarcely anything will be required, except mild diet, slightly acid 
drinks, with flax-seed tea, slippery elm, or some equivalent, to quiet 
the cough. Sponging with tepid water, if done with frequency, mod- 



132 SKIN DISEASES. 



erates the fever, and adds to the comfort of the patient. If the fever 
runs high, take half an ounce of rochelle salt, and use recipe 51. 
Should the eruption " strike in," apply leeches or cups, over the inter- 
nal organ affected, if any, and recall the rash by a mustard bath. 

Those v/ho have been exposed to the contagion, and are liable to 
have the disease, should avoid all unnecessary exposure to wet or 
cold, — keeping the feet warm and dry, and the whole body well clad. 
With these precautions, and a mild, unstimulating diet, much of the 
force of the disease may be broken. 

During the first stages of the disease, bathing the feet once or twice 
a day with hot water, and freely using warm, sweating drinks, as 
saffron, summer-savory, pennyroyal, balm, and mullein tea, and put- 
ting mustard drafts to the feet, will hasten the coming out of the 
eruption. 

Should the breaking out be delayed by excessive fever, give full 
doses of tincture of veratrum viride, or nauseating doses of ipecac, 
antimony, lobelia, or hive-syrup, and teaspoonful doses of compound 
tincture of Virginia snake-root. 

Beside the milder forms of the disease, cases occur, chiefly in broken- 
down constitutions, in which the rash delays its coming out till the 
seventh day, and is then mingled with dark and livid spots, which 
remain, often, for ten or twelve days. The fever is of a low, typhoid 
kind, and the patient is extremely weak and languid. 

In this condition of things, the patient must be supported by tonics 
(49), and stimulants (134), and expectoration promoted by some ap- 
propriate remedy (106), (124). 

If at any stage of the disease, there should be fixed pain in any 
part of the chest, which is made worse by coughing, or by taking a full 
breath, we may conclude there is some inflammation of the chest ; 
and it must be treated as directed for pneumonia. 

Scarlet ¥ by er, — Scarlatina. 

This is likewise an acute inflammation of the entire covering of 
the body, both external and internal, connected with fever which is 
infectious and contagious. 

Symptoms. — The fever comes on somewhere between the second 
and tenth day after exposure. On the second day of the fever, the 
eruption comes out in the form of very small points and pimples, 
which appear either in patches, or constitute a general redness, of a 
bright scarlet color. In Plate I, Fig. 2, the artist has given a fine 
picture of the disease. 

The disease begins with languor, pains in the head, back, and limbs, 
with drowsiness, nausea, and chills ; and these are followed by heat, 
thirst, etc. When the redness appears, the pulse is quick, and the 
patient is anxious, restless, and sometimes delirious. The eyes are 
red, the face swollen, the tongue covered in the middle with white 
mucus, and is studded with elevated points of extreme redness. 
The tonsils are swelled, and the throat red. The greatest degree of 



SKIN DISEASES. 133 



redness is reached on the evening of the third or fourth day from its 
beginning, when a gentle moisture appears, the disease begins to 
decline, with itching, and the scarf-skin falls off in branny scales. 

A swelling or puthness of the flesh, which spreads out the fingers 
in a singular manner, seems to be peculiar to scarlet fever. 

In the first stage of the complaint, the tongue, as stated above, is 
covered with a far ; but as it advances, the tongue often becomes 
suddenly clean, and presents a glossy, fiery-red surface, which is 
sometimes, with the whole lining of the mouth, raw and tender. 

It is peculiar in this complaint, that the inflammation of the throat 
almost always runs into a state of ulceration. As far as can be seen, 
on pressing down the tongue, the throat is swollen and of a deep, 
I florid red ; and on the tonsils may be seen white or gray ulcers. This 
: makes swallowing very difficult, and aggravates the sufferings of the 
I patient. The great amount of mucus in these parts causes also a 
I continual rattling in the throat. 

I The eustachian tube, which extends up to the ear, is apt to get 

' involved in the inflammation, and cause swelling and pain in that 
i j.j^ „2 region. The glands under the ear and jaw 

sometimes inflame, and after a time, they oc- 
casionally break. Abscesses formed in the 
ear, frequently produce some deafness which 
is not easily cured. , 

In the cell-dropsy, which sometimes appears 
after scarlet fever, the crystals of urate of 
ammonia may often be found in the urine 
with the microscope (Fig. 72). 

This disease resembles measles ; but may 

be distinguished from it by the absence of 

cough ; by the eruption being finer, and of a 

more scarlet color (see plate) ; by the rash coming out on the second 

day instead of ihe fourth ; and by the ulceration in the throat. 

Treatment. — In ordinary cases, the treatment should be very simple. 
The apartment should be kept cool, and the bed-covering light. The 
ichole body should be sponged with cool water as often as it is hot and 
dry, and the patient be permitted to take cooling drinks. Beside this, 
in many cases, very little is needed, except to give a few drops of the 
tincture of belladonna, night and morning. 

In some cases where there is a good deal of fever and soreness of 
throat, give tincture of veratrum (124) often enough to keep down the 
pulse. It would be well also to begin the treatment of such cases 
with an emetic, (1) (4) (2). In addition to this, the feet and hands 
should be soaked in hot water, with a little ground mustard, or pul- 
verized cayenne, stirred in. This bath should be continued twenty 
minutes, twice a day, for two or three days. 

The cold stage having passed, and the fever set in, warm water may 
be used without the mustard, etc. If the head be affected, put mus- 
tard drafts upon the feet. Should the bowels be costive, they may be 
gently opened by some very mild physic. 




134 SKIN DISEASES. 



No solid food should be allowed ; but after the first shock of the 
disease is passed, drinks, in reasonable quantities, will be advisable, — 
such as cold water, lemonade, barberry and tamarind water, rice 
water, balm or flax-seed tea, and some thin water gruel. 

To promote the action of the skin, the spirits of nitre, with other 
articles (51), adapting the dose to a child, will be found useful. The 
nitrate of potash is useful, given in one to three-grain doses, dissolved 
in water, every three or four hours. 

The muriatic acid, forty-five drops in a tumbler filled with water, 
and sweetened, and given to a child in teaspoonful doses, is a good 
remedy. 

In very violent attacks, the system sometimes inclines to sink im- 
mediately ; typhoid symptoms show themselves ; there is great pros- 
tration ; the eruption strikes in ; the skin changes to a purple or 
mahogany color ; the tongue is of a deep red, or has a dark-brown 
fur upon it, and the ulcers in the throat become putrid. This is called 
scarlatina maligna ; but it is only a severer form of the same disease. 

The treatment of this form must be different from that recom- 
mended above. It must be tonic. Quinia {Q5) must be freely given. 
Wine whey, mixed with toast water, will be useful. Tincture of 
cayenne, in sweetened water, may be given often in small doses. 
Ammonia (135) may likewise be given as a stimulus. Gargles (245) 
(244) (243) are also required. 

A dropsical affection is one of the most frequent results of scarlet 
fever. It is believed that this seldom occurs, if the warm bath is 
daily used, as soon as the skin begins to peel off. After the dropsy 
has set in, give the warm bath twice a week, and encourage perspira- 
tion by the compound tincture of Virginia snake-root, and similar 
articles. The child should have a generous diet, at the same time, to 
bring up its strength. 

Small-Pox.— Variola. , 

This is another disease characterized by acute inflammation of the 
entire skin, both external and internal, connected with infectious and 
contagious fever. The eruption has the form of red points, which 
soon become pimples, then vesicles, then flattened and scooped-out 
vesicles, then pustules, and finally hard brown scabs. These last fall 
off from the eleventh to the twenty-fifth day, and leave behind them 
small pits and scars. The fever is remittent, and precedes the erup- 
tion some three or four days, — ceasing when the eruption is devel- 
oped, and returning when it has reached its height. The period 
between exposure and the attack of the disease, called incubation^ is 
from five or six to twenty days, — being short in the severe cases, and 
longer in the milder ones. 

Symptoms. — The disease begins with languor and lassitude, with 
shivering, and pains in the head and loins ; with hot skin, and quick- 
ened pulse and breathing ; with thirst, loss of appetite, and furred 
tongue ; with nausea, vomiting, constipation, restlessness, and uni- 



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SKIN DISEASES. 135 



versal prostration. To these symptoms sometimes succeed, difficult 
breathing, cough, drowsiness, and even insensibility. The tongue, 
white at first, soon becomes red at the point, and over the whole 
surface. The fever is highest during the night. The constitutional 
symptoms are more violent just before the eruption, but immediately 
subside, and soon disappear, when the breaking out is established. 
The eruption is at first in the shape of small red points, which are 
hard to the touch, and shaped like a cone, and are proportionate in 
number to the subsequent pustules. In Plate II, the artist has well 
exhibited the developed disease, as well as the progress of the erup- 
tion from day to day. 

Treatment, — Like the two preceding diseases, the ordinary, un- 
complicated form of this requires only the most simple treatment. 
Not much is wanted, except confinement in bed, cooling drinks, cool 
and even temperature, frequent change of linen, and sponging the 
body with cool water. But when what is called the fever of invasion 
is past, and the eruption isfidli/ developed, and has brought along with 
it the secondary fever, then some recipe, as 131, (124) (125) will be 
in place, and some gentle laxative to keep the bowels open (8), — also 
gentle injections, (249) and opiates to relieve sleeplessness and ner- 
vous symptoms. 

Should the system, at this period, appear to be sinking, a more 
generous diet, and a little wine may be allowed. If the brain sufiers, 
apply leeches to the mucous membrane of the nose, or behind the ears, 
and put the feet in a mustard bath (242). If the breaking out appear 
with difficulty, put the patient into a warm bath, and tartrate of anti- 
mony, (104) or Dover's powders may be employed. Gargles will 
frequently be needed for the inflammation, and dryness of the mouth 
and throat (243). Cold sponging may be considered as highly bene- 
ficial, in both the primary and secondary fever. The belladonna like- 
wise is a useful remedy, used in the same way as in scarlet fever. 
The plaster 52, applied to the face, will, it is said, arrest the formation 
of matter, and prevent the unsightly scars which so often cover the 
face of persons who have suffered from small-pox. 

Varioloid. — Varicella, 

Varioloid, or modified small-pox, begins with symptoms similar 
to those of small-pox, but much milder in degree. These symptoms 
are feverishness, nausea, vomiting, pains in the loins and head, and a 
quickened pulse. The eruption comes out on the third or fourth day, 
and looks Hke that of small-pox. It reaches its height the fourth or 
fifth day, and then declines without any secondary fever. The pus- 
tules dry up and form brown scabs which fall off in a few days, and 
leave slight pits, and a few red or purple spots. 

Varicella appears under a variety of forms, called "hives," "swine- 
pox," "chicken-pox," "horn-pox," etc. But they all have a family 
likeness, and need not be described. The treatment of all these forms 
must be conducted on the same principles with small-pox. Sponging 



136 SKIN DISEASES. 



the skin in all these inflammatory conditions has the happiest effect, 
and should seldom be omitted. 

Cow-Pox. — Vaccina. 

This disease exists to some extent among lower animals, and is 
identical with small-pox in man. The immortal Jenner taught the 
world that the pus, taken from the cow having this disease, and intro- 
duced under the skin of man, would produce an eruption similar to 
that of small-pox, and that this would protect the system from the 
latter disease. This was an immensely important discovery, and will 
render the name of Jenner famous through all time. 

It is a question of great importance how far vaccination, or inocu- 
lation with the matter of cow-pox, does, in fact, protect the system 
from small-pox. That it is a protection, to a certain extent, is doubted 
by none. That in some instances it protects through life, is likewise 
generally admitted. Is it a protection in all cases, and through the 
whole life ? Perhaps not, though this is a disputed point. Proba- 
bly the mild form of the vaccine disease does not impress the system 
powerfully enough to last more than a certain number of years. Most 
thinking physicians now believe it is wise to revaccinate occasionally, 
to make sure of the protection. It is done with little trouble, and 
may save a terrible infliction. Plate II, Fig. 4, gives a good idea 
of the appearance and progress of the eruption. 

The Second Group of diseases, characterized by inflammation of 
the true skin, vnthout constitutional symptoms of a specific kind, are 
Erysipelas, Nettle-Rash, False- Measles, and Inflammatory Blush. 

Erysipelas. — St. Anthony s Fire. 

Erysipelas is a diffused inflammation of the skin, affecting only a 
part of the surface of the body, and is accompanied by a fever, which 
is generally thought to be infectious and contagious. The local in- 
flammation is disposed to spread; it extends deep, and is attended 
by swelling, a tingling, burning, and pungent heat, and by a redness, 
which disappears when the skin is pressed by the finger, and returns 
on remitting the pressure. 

Sjiiiptoms. — The constitutional symptoms are chilliness and shak- 
ing, succeeded by heat ; lowness of spirits, lassitude, pains in the 
back and limbs, pains in the head, quick and hard pulse, thirst, loss 
of appetite, white and coated tongue, bitterness of mouth, nausea, 
vomiting, pain in stomach, and costiveness. 

These symptoms go before the local inflammation several days; 
they increase with the redness of the skin, and disappear upon its 
decline. The nervous system is sometimes severely affected, and 
indicated by low, muttering delirium. At the close of the inflam- 
mation there is generally a relaxation of the bowels, and the scarf- 
skin peels off. Sometimes matter forms under the skin, and occa- 
sionally mortification occurs. The face is the most frequent seat of 



ERYSIPELAS 



PJ 3. 






fi^.l. 




Fui. P 



SKIN DISEASES. 137 



the disease. It commonly begins on one side of the nose, and soon 
spreads over one side of the face, closing up the eye, and changing 
the features in a shocking manner. See Plate III, Fig. 1. 

Somewhere about the third, fourth, or fifth day, very minute blisters 
appear on the inflamed parts, filled with water, which increases until 
the blisters break and let it out. The disease comes to a head on the 
eighth or ninth day, when the blistered parts dry, and the skin begins 
to peel off. 

Treatment. — In the treatment two things are to be done, — to sub- 
due the fever, and the local inflammation. The fever is assuaged by 
rest, milk diet, gentle laxatives, (26) (21), etc.; and by the use of 
tincture of veratrum. For the local inflammation, various things have 
been advised, but nitrate of silver, on the "whole, has the preference. 
First wash the inflamed part with soap and water to remove any 
oily sub.stance, and wipe the skin dry. Then moisten the inflamed 
and surrounding skin, and pass over it a stick of nitrate of silver, 
touching not only the inflamed part, but going even an inch beyond 
it on all sides. Or, a solution of nitrate of silver and nitric acid, (53) 
will in many cases, according to Dr. Higginbottom, do even better. 
A solution of coperas (215) is a good application. So is 303. 

In mild cases, flour may be dusted on the inflamed part from the 
dredging-box. Warm fomentations are also useful, and cloths wet 
with water, and laid on. A solution of per. chloride of iron, applied 
to the inflamed skin, is much used now. 

In erysipelas the powers of the system are generally reduced, and 
tonics, such as quinine, wine, etc., are generally required. Dr. Robert 
Williams, — high authority in these matters, — says he puts his pa- 
tients upon milk diet, gently opens the bowels, and gives them, daily, 
from four to. six ounces of port wine, together with sago, and that he 
seldom has to change this course, whatever the symptoms. 

For the inflamed skin, a tea made of buckwheat meal, is a good 
wash. Alcohol and water, or new rum, may be used for the same 
purpose. 

Nettie-Rash. — Urticaria, 

» 

Nettle-rash begins with fever, which lasts two or three days, 
when wheals of various shapes, round, oval, and oblong, appear in 
the midst of red, slightly elevated patches, attended by great itching 
and tingling, as if the common nettle had been applied to the skin. 
The wheals go ofl* during the day, and come again at night. The 
eruption is often a symptom of other diseases, or of mental anxiety. 
Sometimes it is the effect of articles of diet. Children have it occa- 
sionally while cutting teeth. A lighter form of the disease exists, in 
which the wheals appear and disappear at short intervals, according 
to the heat of the weather, the exercise, diet, etc. 

Treatment, — The treatment varies according to the cause of the 
disease. If this be anything offending the stomach, especially if it be 
putrid fish, an emetic (2) (4) will be required, foUowed by brisk 

18 



138 SKIN DISEASES. 



physic (29). After which take a few doses of quinine (67). For exter- 
nal application, the lotion (216) or common vinegar and water (215) 
will be useful. Dr. Wilson recommends corrosive sublimate, etc. (217) 
as the very best lotion to apply outwardly. 

The diet should be simple and cooling, all stimulating food and 
condiments being avoided. 

Rose Rash. — Roseola. — False Measles, 

Symptoms. — The summer rose rash appears first on the arms, face, 
and neck, thence it spreads over the whole body, producing tingling 
and itching. It is usually preceded by the symptoms of fever-chills, 
succeeded by flushes of heat, languor, pains in the head, back, and 
limbs, restlessness, quick pulse, and thirst. The rash appears in small 
irregular patches, paler than those of measles, and of a more roseate 
hue. There is some hoarseness from inflammation of the throat. The 
rash never continues more than five days, unless it be merely partial, 
in which case it sometimes comes and goes at intervals for weeks. 
If it "strike in," it generally produces disturbance of the stomach, 
headache, and faintness, which are relieved by its reappearance. 

The autumnal rose rash is in more distinct patches than the for- 
mer, of a circular figure, slightly elevated, and of a dark damask-rose 
hue. Seldom any fever, or itching and tingling. 

Treatment. — For the first-described form of the disease, light diet, 
acid drinks, and gentle laxatives ; for the second, recipe 59, or 51, ac- 
cording to convenience. 

Inflammatory Blush. — Erythema, 

What is called marginated inflammatory blush, is a mottled, red, 
smooth fulness of the skin, occurring on the extremities and loins, in 
irregular patches, bounded on one side by a hard, elevated, red border. 
This species of the disease attacks old people, and indicates some 
internal disorder, which is dangerous. 

Another form of the complaint appears on the arms, neck, and 
TDreast, in extensive, bright-red, irregular patches, slightly elevated. 
The redness, at its height, is very vivid, and continues about a fort- 
night, when it assumes a purplish hue in the centre. 

Treatment — Light diet, gentle purgatives (21), opiates (218) to 
allay the tingling and secure sleep, and the mineral acids (63), with 
bitter tonics, comprise all that is required, except sponging with water, 
and friction. 

Watery Pimples. 

We now come to a class of diseases characterized by watery pim- 
ples. Wilson says they are distinguished by " effiisive inflammation 
of the derma," which means that there is inflammation of the true- 
skin, which causes water to be poured out on top of the derma, and 



SION DISEASES. 139 



underneath the scarf-skin, causing the latter to be lifted up in the form 
of small or large blisters, or vesicles. At first the fluid in these pim- 
ples is transparent, but in a short time becomes milky. Sometimes 
this fluid absorbs ; at other times, it dries up, and with the cuticle, 
scales off as scurf. 

Humid Tetter. — Eczema. 

An eruption of minute, round pimples, about the size of a pin's 
head, filled with a colorless fluid, and terminating in scurf. It is gen- 
erally a symptom of a feverish state, and is preceded by languor, 
faintness, perspiration, and a pricking and tingling of the skin. 

Another species of this disease is called sun heat, which is an erup- 
tion of vesicles without any redness, of a white or brownish color. 
These vesicles generally terminate in brownish-yellow scabs. It oc- 
curs only in summer, and affects those parts which are uncovered. 

In stiJl another species, the eruption is attended with pain, heat, 
itching, intense smarting, and a swelling of the affected part. When 
the blisters break, the water which runs out irritates and inflames the 
skin, which becomes red, rough, and thickened, — covered sometimes 
with a thick crust. 

Treatment. — Low diet, cooling drinks, gentle purgatives, warm 
baths. In old chronic cases, apply externally either lime water, or 
corrosive sublimate (212) in solution. In the second and third forms 
of the affection, apply externally, a solution of nitrate of silver (219). 

Tetter— Shingles. — Herpes. 

After a slight feverish attack, lasting two or three days, clusters 
of small, transparent pimples, filled sometimes with a colorless, some- 
times with a brownish lymph, appear on the cheeks or forehead, or 
on the extremities, — and at times on the body. The pimples are a 
little larger than in eczema, — about the size of a pea. After a few 
days, the vesicles break, pour out their fluid, and form brown or yellow 
crusts, which fall off* about the tenth day, leaving the surface red and 
irritable. The eruption is attended with heat, itching, tingling, fever, 
and restlessness, especially at night. Ringworm is a curious form of 
herpes, in which the inflamed patches assume the form of a ring. 

Treatment — Light diet, gentle laxatives. If the patient be ad- 
vanced in life, and feeble, a tonic (64) will be desirable. For external 
application, white vitriol (220), or an ointment of sulphuret of lime 
(174), or elder-flower ointment, etc. (175). 

Itch. — Scabies. 

To this disease all classes are liable, though it is much less com- 
mon than in former years. It is found frequently among the poor, 
whose condition in life does not give them the means to guard at all 



140 



SKIN DISEASES. 



points against it ; but it is most common among such as neglect per- 
sonal cleanliness. 

S^Tiiptoms. — An eruption of distinct, cone-like, watery pimples, 
which are transparent at the summits, and are accompanied by an 
excessive itching, which is made worse by high-seasoned food, by 
drinking liquor, and by the heat of the bed. When these pimples are 
scratched and torn, a sticky, watery fluid is poured out, which forms 
small scabs ; and, in time, if the disease is not cured, these scabs being 
often torn off, extensive sores are made. 

Cause, — It will excite the wonder of many readers to state that 
animals of so small a size as scarcely to be seen with the naked eye 
exist in the skin of man. Yet such is the fact; and it is the presence 
of these minute creatures, or the effect of their presence, which con- 
stitutes the disease called itch. The little creature (acarus scabiei, 
by name), a species of mite, is one seventy-seventh part of an inch in 
length ; and when closely inspected under the microscope, is really a 
beautiful, I may say an elegant, animal. Here are a front, a side, and 
a back view of him, well done by the artist. 



Fig. 73. 



Fig. 74. 



Fig. 76. 






His Method of Attack. — When placed upon the skin, the little 
fellow, like the squirrel and other ground animals, sets himself to make 
a hole through the scarf-skin with his head and fore feet. Into this 
he pushes his whole body. He then begins to burrow himself in the 
derma or true skin — making a channel many times his own length, 
at the end excavating a chamber where he sleeps, and whence he goes 
out to do his day's work at mining, or boring for food. When tired 
of this sleeping apartment, he digs onward and scoops out another. 

This travelling, and boring, and turning about in an organ as sensi- 
tive as the true skin, must, of course, occasion a tickling and itching; 
and from this circumstance the disease took its name of itcL But 
this itching is not painful. James the First is said to have remarked 
that the itch was fitted only for kings — so exquisite is the enjoyment 
of scratching. Probably it is a royal luxury. Be that as it may, most 
persons would consent to have it all done by royal fingers. They 
have been used for meaner purposes. 



SKIN DISEASES. 141 



Treatiueut. — Whatever will kill the little animal described above, 
will cure the itch. Various agents have been employed for this purpose, 
but none have been found equal to sulphur. The compound sulphur 
ointment is a sovereign remedy for the disease. Four ounces of this 
should be well rubbed into the skin, before the fire, morning and even- 
ing, for three or four days. This will put an end to the whole colony 
of these sovereign squatters upon forbidden soil. 

Two ounces of sulphuret of potash, and the same amount of soft 
soap, dissolved in a pint of water, and applied well to the skin, is 
used in many cases with good effect. 

Caustic potash, one part to twelve parts of water, applied in a sim- 
ilar way, is said to be a pretty sure remedy. 

A solution of the chloride of lime, used as a wash, will often effect 
a cure. 

The ointment of the American hellebore sometimes does well. 

Before applying any of these preparations, let the skin be washed 
with warm water and soap, and well dried. 

Rupia. 

This is from a Greek word which means dirt, from the dirt-colored 
crusts which are formed after the breaking of the large watery pim- 
ples. The vesicles are like those of eczema and herpes, except that 
they are larger. This is distinguished from all other skin diseases by 
the formation of unhealthy, foul, and burrowing sores, which pour out 
a reddish matter in such quantities that it collects and dries upon the 
sore, and forms a crust of great thiokness, — sometimes of the size 
of an oyster-sh&ll. Rupia has its origin in a weakly and debilitated 
constitution, and cannot be cured without renovating the whole sys- 
tem. 

Treatment. — Warm baths once or twice a week, with generous 
and nutritious diet. Tonic medicines (63) (51) (67) (61) (65) will be 
required. For external treatment, dust the surface of the ulcers with 
cream of tartar, or apply nitrate of silver (214) (119) (220), white 
vitriol, etc. 

Pemphigus. — Pompholix, 

The first of these terms is from the Greek, and means a bubble; the 
second, pompholix, is from the same language, and means a vmter- 
bubble. This is still more applicable to the disease in hand, which 
consists, in fact, in the raising up of the scarf-skin in the shape of 
bubbles, containing a watery fluid. These bubbles are just like com- 
mon blisters. They vary from the size of a split pea, to that of a 
hen's egg. They rise up very rapidly, and break in two or three days, 
leaving a raw surface which soon becomes covered by a thin crust. 

Treatment. — Similar to that for Rupia, with the addition of iodide 
of potassium (140), and applying the stick nitrate of silver to the 



142 SKIN DISEASES. 



whole surface of the ulcer, and a short distance beyond it on all sides, 
or the ointment (176). 

Mattery Pimples. 

Another natural group of skin diseases are distinguished by an 
eruption of pimples, filled, not with water, like those just described, 
but with matter. The pimples of this class are not transparent, or 
whitish, but opaque and yellovj from the first. The matter is poured 
out upon the true skin, and raises up the scarf-skin, in the same way 
as the watery pimples. As in the preceding diseases, too, the drying 
up of the matter forms crusts. But these pimples are never so small 
as those of eczema, nor so large as those of pemphigus. 

Crusted Tetter. — Impetigo, 

This eruption consists at first of slightly-elevated pustules or pim- 
ples, closely congregated, with an inflamed border. These break, and 
the surface becomes red, excoriated, shining, and full of pores, through 
which a thin, unhealthy fluid is poured out, which gradually hardens 
into dark, yellowish-green scabs. These scabs sometimes look like a 
dab of honey dried upon the skin. This has given impetigo the 
name of " honey disease," or honey scab. This honeyed look is well 
represented in the crusts which form on the lips and ears of children. 
Sometimes these scabs cover nearly the whole face, and are called the 
milk crust This is putting the agreeable words milk and honey to 
rather questionable uses ! When this crusted tetter invades the head 
or scalp, it causes the hair to fall, and becomes what is called a scall. 

Treatment. — The vapor bath, and water dressing. The following 
ointments are useful : oxide of zinc, white precipitate, or diluted 
nitrate of mercury (178). Hydrocyanic acid (221), applied externally, 
has a fine effect. The crusts should first be removed by a weak lye 
made from hard-wood ashes, or potash ; then, after applying one of 
the ointments above, or the lotion, cover the part with oil-skin. K 
the crusts are on the head, the hair should be cropped off before the 
remedies are applied. 

Papulous Scall. — Ecthyma, 

The mattery pimple called ecthyma is developed on a highly in- 
flamed skin. The bladders are about the size of a split pea, and are 
surrounded by a broad ring of redness. They are generally separate, 
not clustered like impetigo. They are scattered over various parts of 
the body, and are followed either by a hard black crust, or by a sore. 
The disease is either acute or chronic. The latter attacks weakly 
children, and persons reduced by sickness or low living. 

Treatment. — For the acute form, low diet, gentle laxatives, with 
ointment (176), and the cold sponge bath on the sound parts. For the 



SKIN DISEASES. 143 



chronic form, (140) (65) (63) (61) (48) to be taken internally, and 
(176) (175) (214) (211) for external application. 

Scaly Eruptions. • 

The scaly eruption is called dry tetter. It is an inflammation of 
the true skin, and is distinguished from the rashes and pimples by the 
alteration of the scarf-skin. The diseases forming this group are 
three in number, — lepra^ psoriasis^ and pityriasis. 

Leprosy. — Lepra, 

In this disease, the eruption makes its appearance as a small, 
salmon-red spot, raised a little above the surrounding skin, and con- 
stituting, in fact, a flat pimple, almost as large at the top as at the 
bottom. On top of this pimple, the scarf-skin becomes rough, and 
after a little while, a thin scale is produced. New layers are added 
to its under surface, and it accordingly grows thicker. It has a bright, 
silvery lustre. These scaly spots multiply, and become the form of 
leprosy called lepra guttata^ from the Latin gutta^ a drop, the scales 
looking like drops of water on the skin. 

But the eruption more frequently spreads out into circular patches, 
of the size of a fifty cent piece. These generally appear below the 
elbows and knees, and on the breast and shoulders, and back of the 
hands. Sometimes the entire hand is covered with scales of a pecu- 
liar silvery whiteness. These patches heal from the centre. 

Psoriasis. 

This differs from lepra in the eruption being more irregular. The 
spots sometimes come out in thick clusters, and blend in various ways. 
Instead of appearing in distinct circular forms, as in leprosy, the 
patches are irregular, and of every size. Instead of one well-formed 
and thick scale, there are mapy small and thin ones. And instead of 
a depressed centre with rising edges, the surface is level. While lep- 
rosy is a circular dry tetter, this is an irregular dry tetter. 

Pityriasis. 

This is much like the two preceding, except that it gives rise to a 
copious production of very small bran-Uke scales. Indeed, its name 
is from the Greek, and means chaff" or bran. It is a branny tetter. 
It may occur on any part of the body. 

Treatment. — When the skin is highly inflamed, and stiff" with heat, 
pain, and itching, the diet should be light, and the drinks of a cooling 
and unexciting kind. The warm bath, and gentle friction of the skin 
are useful. Laxatives or tonics may be employed, according to the 
indications, — frequently laxatives first, and tonics afterwards. The 
specific remedies for curing the disease are, corrosive sublimate (139), 



144 SKIN DISEASES. 



iodide of potassium (140), arseniate of iron (68), Fowler's solution, 
in two-drop doses, three times a day ; or Donovan's solution, in five- 
drop doses, three times a day. For external application, use a nap- 
thaline ,ointment (177), zinc ointment, white precipitate ointment, 
diluted nitrate of mercury ointment, or solution of corrosive subli- 
mate (212). 

• 
Dry Pimples. 

These are distinguished by the high degree of irritation of the skin 
which they create. They are exceedingly troublesome, not only from 
the distress and itching they occasion, but because they are likely, in 
consequence of this to be torn into painful and obstinate sores. 

When appearing in children, they are called red gum, and tooth- 
rash. In grown persons, one form is named lichen, and another, dis- 
tinguished by excessive itching, prurigo. 

In this form of pimples, the fluid is not poured out upon the sur- 
face of the true skin, — as in several of the -preceding diseases, — but 
is collected within the tissue of this organ, and the pimples feel hard 
under the finger. 

The tooth rash of infants is always accompanied with some fever- 
ishness, caused generally by irritation of -gums from growing teeth, — 
occasionally by flannel worn next the skin. 

Lichen has a variety of forms. In one case the pimples are of a 
bright red, in another, bluish or livid. In one case they appear in 
circular groups, in another, they produce great disorganization of the 
skin, and occasion terrible suffering. 

Pnirio'O is a still more cruel disease than lichen. The pimples are 
not very manifest, but the skin is thickened or swollen, and condensed. 
The suffering from it is terrible. It gives one no sleep, night or day. 
That form of it called ant-bite prurigo, gives the sensation of millions 
of ants eating the flesh, or as many red-hot needles piercing it. This 
renders the existence of many elderly persons a terrible burden. 

Treatment. — Careful diet, and gentle cathartics or tonics, accord- 
ing to the condition of the system. Externally, the cold salt-water 
sponge bath, and glycerine, applied with a soft sponge, vinegar and 
water, corrosive sublimate (222), creosote ointment, the diluted nitrate 
of mercury ointment, laudanum and sulphur (179), prussic acid, etc. 
(171). For relieving the terrible itching of the private parts, which 
females sometimes suffer, I have found morphine (223), for external 
use, very effectual. 

Lupus. 

This makes its appearance in the form of one or more circular 
elevations, of a dull red or salmon-color, and partially transparent. 
When pressed under the finger, these elevations are found to be soft, 
and when the finger is removed, they are flat and whitened. They 
generally appear on the face, and particularly the nose. 



LUPUS NONEXEDENS. 



PI. 4. 




Jff.Buffords lith. 



SKIN DISEASES. 14-: 




In another and worse form of the disease, the tubercles aye harder ; 
and after a time, they become covered with thin brown scabs, which 

are scratched off, and followed by others, 
^^' '^' and these by others, until ulcers appear, 

which are sometimes slow and some- 
times rapid in their progress. The whole 
nose has been destroyed by them in a 
month. (See Fig. 76.) This is one of 
the diseases which Erasmus Wilson 
thinks, and, in my judgment, correctly, 
to be, like scrofula, the result of the 
syphilitic poison, filtered through the 
blood of several generations. (Bee col- 
ored Plate IV.) The artist has here 
given a beautiful likeness of the disease. 

Treatment. — The internal remedies 
are iodide of arsenic (141), and iodide of 
potassium (140) ; the external, vinegar of 
Spanish flies ; and to promote the heal- 
ing of the ulcers, a weak solution of nitrate of silver (211) (214) is 
adapted. 

Warts and Corns. — Verruca — Tylosis — Clovus. 

In the derma or true-skin, there are a great many small arteries, 
veins, and nerves, united together, and formed into loops (see cut 43), 
resembling, in shape, the peaks of miniature mountains. These are 
called papillcE. These loops, frequently, without any apparent cause, 
take on a disposition to grow, and by extending themselves upward, 
they carry the scarf-skin along with them, which is thickened : and 
together they form what is called warts. Corns are formed by a 
somewhat similar growth of the papillae, brought about by the pres- 
sure and friction of tight boots and shoes. 

Treatment. — For warts, take a piece of diachylon plaster, cut a 
hole in the centre the size of the wart, and stick it on, the wart pro- 
jecting through. Then touch it daily w'ith aqua fortis. Nitrate of 
silver sometimes answers well for touching it. They may be taken 
off very neatly, sometimes, by tying a string tight around them. 
Corns should be shaved down close, after being soaked in warm 
water and soap, and then covered with a piece of wash-leather, or 
buckskin, on which lead._ plaster is spread, a hole being cut in the 
leather the size of the corn. They may be softened, so as to be 
easily scooped out, by rubbing glycerine on them. Manganic acid de- 
stroys warts and corns rapidly. Bunions, which affect the joint of the 
great toe, must be treated with fomentations, and sugar of lead water 
(224), when there is considerable inflammation, wdth rest and a hori- 
zontal position. But the best cure for corns and bunions, is to put 
away tight shoes. 

19 



146 SKIN DISEASES. 



Mother's Marks. — Nevus. 

The small vessels of the skin, called capillaries, suffer certain alter- 
ations of structure which pass under the name of mother's marks. 
These marks are simply a great dilatation of these minute blood 
vessels. These marks vary in size from a mere point to a patch of 
several inches square. 

The smallest of all is the spider mark. It is a small red point, 
from which several little straggling vessels spread out on all sides. 
Sometimes this is of the size and appearance of a red currant ; at 
other times, of a strawberry or raspberry ; and occasionally it is even 
much larger, and is compared to a lobster. 

When the circulation is active through them, or the individual is 
excited by exercise, or by moral causes, these marks are of a bright 
red color. Some are naturally livid and dark-colored, and look like 
blackberries, and black currants. The blueness of these is owing to 
the vessels being still more stretched and dilated, and to the conse- 
quent slower passage of the blood through them, which gives more 
time for its change from the arterial red to the venous blue. 

Treatment, — If the mark is not making progress, it had better be 
let alone, or only subjected to gentle pressure by putting a piece of 
soap plaster over it. When its course is threatening mischief, it is 
sometimes cured by pencilling a small portion of its surface, from 
time to time, with nitric acid. 

Disordered State of the Nerves of the Skin. 

Itcliin^. — Pruritus. This is supposed to be dependent on an 
altered condition of the nerves of the skin, and consists in a painful 
sensation of itching. There is no perceptible alteration in the ap- 
pearance or structure of the skin. This itching is thought, generally, 
to be a result of sympathy, through the nerves, with some diseased 
and excited condition of a distant part. The itching is brought on 
by the most trifling causes, and for hours may deprive the sufferer of 
every particle of repose. It more frequently affects the fundament, 
or the private parts, particularly the scrotum. 

Treatment. — As this disease is only a symptom of several others, 
the constitutional treatment belongs under the heads of these other 
diseases. The local applications for relieving the itching are, a solu- 
tion of sugar of lead (224), of white vitriol (220), of corrosive subli- 
mate (212), diluted nitrate of mercury ointment, and poppy fomenta- 
tions. Also (223). 

Disorders Affecting the Color of the Skin. 

Colored Patches. — Maculce. The depth of color in the skin depends 
on the amount of a certain coloring matter, called pigment, incorpo- 
rated with the deeper and softer portion of the scarf-skin. In the 



SI«N DISEASES. 147 



scarf-skill of the inhabitants of northern latitudes, there is but little 
of this pigment ; in that of the dwellers in Africa, there is a great 
deal ; among the inhabitants of Southern Europe, the quantity is 
intermediate between the two. 

The depth of color in the skin, depends on the energy of its action. 
In the tropics, where light and heat are in excess, the skin is stimu-( 
lated to great action, just as vegetation is, and the color is increased 
and intensified. This is illustrated every year before our eyes. In 
summer under the heat of the sun and the flood of light, the pigment- 
forming power is increased, and the fairest skin is browned ; while 
the withdrawal of these forces, leaves the winter's scarf without pig- 
ment, and blanched. 

What the sun and light do, under natural circumstances, diseased 
action may effect. Hence we occasionally meet with alterations of 
color in the skin, from a disordered state of the system. We witness 
the forrhation of patches of dark color and irregular shape on various 
parts of the body. Sometimes they are raised above the level of the 
skin, and are called moles. At other times, they have no elevation, 
and spread over the whole body. 

Occasionally, from some peculiarity of constitution, the pigment is 
diminished, and white patches appear all over the body. At other 
times, a black person will become completely white. Such are called 
albinos. 

In many cases the coloring of the skin has varieties of tint, as 
when persons of light complexion, are, in the summer season, covered 
w^ith yellow spots, like stains. These spots are known by the name 
of freckles^ or, in learned language, lentigo. 

Treatment. — It is generally best not to meddle with a mole. If it 
be very unsightly, let it be removed by two incisions, taking out an 
elliptical portion of skin, and closing the wound with sticking plaster. 
In the case of bleached places, apply the shower bath, tonics, and a 
stimulating liniment (163) to the faded spots. For the change of color 
called sun-burn, a liniment (191) of lime water, etc., is the best pre- 
paration. For freckles, use lime water (191), or, perhaps, still better 
(222). 

Disorders of the Sweat Glands. 

The perspiration is sometimes greatly increased above nature's de- 
sign. This is, technically, idrosis. In other instances there is too 
little sweating. This is called anidrosis. Sometimes the perspiration 
is so altered in its physical qualities as to have some peculiar smell. 
This is osmidrosis. In some rare instances, according to old writers, 
she sweat was changed in color. This was chromidrosis. And now 
and then a case occurs of bloody perspiration, of which, the most 
memorable case on record, is that of the Redeemer of men, who, in 
the garden, sweat great drops of blood. Several cases of this are 
recorded in medical books. It is called hcemidrosis. 

The proper action of the skin being so vitally important to health, 
these changes often involve very serious consequences. 



148 SKIX DISEASlS. 



Treatiiieiit. — Either too much or too little sweating can generally 
be corrected by the cold or warm bath, friction, tonics, and proper 
clothing. 

Disorders of the Oil-Glands and Tubes. 

That the skin may be limber, healthy, and fit for use, it is neces- 
sary to have it oiled every day. For this object, the Creator has 
wisely provided, by placing in the true skin a large number of very 
small glands and tubes, w^hose office it is to prepare and pour out 
upon the surface the proper amount of oil. The gland, regular 
little oil-pot, is in the true skin ; and from it a piece of hose or tube 
runs up through the scarf-skin, through which the oily fluid is poured 
out. Some of these tubes are spiral, others are straight. On some 
parts these vessels do not exist; on others they are quite abundant, — 
as on the face, nose, ears, head, eye-lids, etc. They produce the wax 
of the ears ; and on the head, they open into the sheath of the hair, 
and furnish it with a hair-oil or pomatum better than the chemist can 
make. 

These little vessels are always at work, when the skin is healthy ; 
and no persons need be afraid to wash all over every day, lest, as the 
Boston Medical Journal taught, the skin will be injured by having the 
oil removed from it. You might as well be afraid to eat a meal of 
victuals, lest the saliva should all be swallowed with it, and none be 
left for future use. There is oil enough where that upon the skin 
comes from, and the vessels which produce it are not injured by work, 
any more than the muscles of the legs are by walking. 

Grubs or Worms, — But, unfortunately, the skin is not well taken 
care of in all cases, as in cities and towns where sedentary habits pre- 
vail. Here, the actions of the skin, instead of being regular and com- 
plete, are often sluggish and imperfect; and the contents of the oil- 
cells and tubes, instead of flowing easily, become hard and impacted, 
and the vessels are not emptied. When this matter becomes station- 
ary, dry, and hard, it distends the tube, and fills it to the surface ; and 
then coming in contact with the dust 
and smoke of the atmosphere, the ends ^i®- ~- 

become black, and look like the heads of 
worms. These spots are common on 
the nose and face of persons who have 
a sluggish skin. They may be squeezed 
out by pressing the nails on each side of 
them. These are called grubs and 
worms, or, technically, comedones. When 
this matter produces inflammation of the 
tube, there is then a black spot in the 
middle of a red pimple, and the disease 
is called spotted acne. Now and then 
the oily matter becomes very hard, pro- 
ducing spine-like growths, and even horns (Fig. 77) ; and again, it col- 
lects and forms soft tumors, as wens, etc. These are technically 




SKIN DISEASES. 



149 



called encysted tumors. Sometimes the action of the glands is too 
great, and oil is poured out so profusely that the face shines with it. 
At other times there is so little that the skin is dry and harsh. In 
the hardened, oily matter, which constitutes grubs, are found small 
animals, which Dr Wilson calls the "animal of the oily product of 
the skin." Here are three views of him. 



Fio. 79 



Fig. 80. 




Treatment. — For roughness and harshness of skin, wash with soap 
and water every night, and rub well into the skin after the bath, and 
in the morning, the ointment (180), and take a dose of sulphur, etc. 
(23), twice a week. Or, rub the skin every morning with a damp 
sponge, dipped in fine oat-meal, and after drying the surface, the 
liniment (164) may be applied. The spinous variety, or porcupine 
disease, requires washing with a quart of warm water, having a large 
teaspoonful of saleratus dissolved in it, and the use of the ointment 
(181) twice a day. For grubs, stimulate the skin, by washing it with 
strong soap suds, twice a day, and rubbing briskly w^ith a coarse towel ; 
and by using the corrosive sublimate (225) as a lotion. 

A spare diet will do much towards improving the skin in many 
cases. 



Barbers' Itch— Jackson's Itch. — Sycosis. 

This is very much like acne^ — only differing from it in its location. 
It appears chiefly on the hairy parts of the face, — the chin, the upper 
lip, the region of the whiskers, the eyebrows, and the nape of the 
neck. It consists in little conical elevations, which maturate at the 
top, and have the shaft of a hair passing through them. These pim- 
ples are of a pale yellowish color. In a few days they burst, and the 
matter running out, forms into hard, brownish crusts. These crusts 
fall off in one or two weeks, leaving purplish, sluggish pimples behind, 
which disappear very slowly. 



150 SKIN DISEASES. 



The eruption is preceded by a painful sensation of heat, and tight- 
ness of the skin. 

The disease is supposed to be brought on frequently by using a 
dull razor in shaving. It is very obstinate, — often lasting for many 
months, and even for years. 

Treatment. — The most important part of the treatment is the re- 
moval of the cause. The beard must not be pulled with a dull razor ; 
the shaving had better be discontinued altogether, and the beard be 
merely cropped off with scissors instead. All intemperance in eating 
and drinking, and exposure of the face to heat, must be avoided. A 
light, cool diet will do much towards curing the disease. 

The nitrate of mercury ointment, and a solution of oxalic acid, are 
the best applications. K one does not succeed, try the other. 

• Disorders of the Hair and Hair Tubes. 

The hair is an appendage to the scarf-skin, and is intended to be 
both useful and ornamental. 

It is subject to several disorders. It may grow too long, or too 
thick, or it may appear in an improper place. This last happens in 
the case of those little spots and patches, which disfigure the face, 
and are called moles. The hair may be defective in its growth, or 
may fall off prematurely from various causes, or in the natural course 
of things from old age. This last is called calvities. It may change 
its color, too, under a great variety of circumstances, and at nearly 
every age. It is not very uncommon to find a single lock varying in 
color from that which surrounds it. Old age, the winter of life, nat- 
urally brings the frosted locks ; but they frequently appear also upon 
the heads of younger persons. Strong mental emotions, such as fear, 
grief, or sorrow, may bring a bleaching of the hair in a brief period, 
or even suddenly. Byron, in his " Prisoner of ChiUon," beautifully 
refers to this fact : 

" My hair is gray, but not with years, 
Nor grew it white 
In a single night. 
As men's have grown from sudden fears." 

PorrigO. — There is a troublesome disease of the hair and hair tubes 
called porrig'O. It begins with the formation of a thin layer of scurf 
either around single hairs, or in patches which enclose several. These 
patches frequently have a circular form, which give to the affection 
the character of a ring-worm. The hair tubes are generally a little 
elevated, in the shape of papillae, which gives to the diseased scalp the 
appearance of " goose-flesh." These hairs, losing their proper nour- 
ishment and healthiness, break off at unequal distances from the skin, 
leaving their rough ends, twisted, and bent, and matted into thick 
grayish and yellow crusts. Upon the surface of these crusts may 
generally be seen the ends of a few hairs, looking like the fibres of 
hemp or tow. The scratching causes inflammation of the skin after 
a time, and matter is poured out, which still further mats the hair, 



SKIN DISEASES. 151 



and thickens the crusts. There are several varieties of this disease, 
differing slightly from each other ; but this general description will 
answer all practical purposes for this work. 

The reader will often notice a disease of the hair-glands, character- 
ized by a yellowish and dirty-looking powder, covering the scalp and 
hairs. This matter is collected at the mouths of the follicles, and 
considerable of it is strung upon the hairs like beads. Pull out a hair, 
and the root will be found thin, dry, and starved in its appearance. 
In this disease, it is difficult to keep the hair cleansed, or to prevent 
its falling off. 

Favus. — Still another disease, called favus. is known by the collec- 
tion of a yellow substance, at first, around the cylinder of the hair. 
This substance, after a time, spreads out upon the scarf skin, and 
dries into yellow crusts, in the form of a cup, around the base of each 
hair. A number of these cups, collected together, look like the cells 
of a honey-comb. This disease is contagious, and is communicable 
by contact to any part of the skin. 

Treatment. — For removing the hair from particular parts of the 
scalp, it is common to resort to depilatories. Of these, the recipes 
260, 261, 262, are frequently used, and are as good as those adver- 
tised ; indeed, they are the same. 

To prevent loss of hair, and to restore it when lost, the circulation 
should be stimulated in the small vessels of the scalp. With this 
view, washing the head every morning with cold water, drying it by 
friction with a rough towel, and brushing it to redness with a stiff 
hair-brush, are excellent. To these should be added some stimulating 
ointment (182), or liniment (257) (258) (259). These last are about 
the best known preparations for causing the growth of the hair. 

Ringworm of the scalp requires attention to the diet, and such rem- 
edies as will improve the general health, with stimulating applications 
externally (257) (258) (259). 

To color the hair, seven preparations are used." Of these, 94 is 
about the best. It produces a beautiful black. A preparation of sul- 
phur and sugar of lead (264) is the famous compound recommended 
by General Twiggs, and extensively used. Preparations of nitrate 
of silver (265) (266) (311) are much in use in some quarters. They 
perhaps give a finer black to the hair, but they render it dry and crisp, 
and they will stain the skin, if care is not used in applying them. 

In Favus, the two great objects to be gained are, to remove all local 
causes of irritation, and to excite the diseased hair glands to healthy 
action. The first object is effected by cutting off the hair with the scis- 
sors, and removing the crusts by washing the scalp with castile soap 
and water. It may be well first to wet the crusts through with corro- 
sive sublimate (212), in weak solution. The washing with soap and 
water should be repeated every day, and be followed by rubbing into 
the scalp a stimulating ointment (183). A very weak solution of the 
acid nitrate of mercury (226), applied every other day, with a camel's 
hair brush, sometimes produces excellent effects. 



DISEASES OP THE BRAIN Am NERVES, 



The brain and spinal cord are the great centres of the nervous 
system. 

The brain produces sensation, thought, and voluntary motion. When 
this organ is diseased, therefore, we may expect one of these functions 
to be either disturbed or destroyed. 

Of Sensation there are various disturbances, perversions, and sus- 
pensions, caused by disease of the brain and nerves ; such as nausea, 
giddiness, specks floating before the eyes, ringing in the ears, decep- 
tive tastes and smells, intolerable itching, neuralgic pains, boisterously 
high spirits, depression without apparent cause, anxiety, and dread. 

Tliong'ht, in like manner, is disturbed and perverted in many ways. 
There is high delirium, 'dulness and confusion, loss of memory, weak- 
ened judgment, and every degree of stupor, down to entire loss of 
consciousness. 

Voluntary Motion is perverted and destroyed in muscular twitch- 
ings, trembling of the limbs, spasmodic stiffness, involuntary jerkings, 
convulsions, muscular debility, and palsy. 

The brain is composed of three parts, — the cerebrum, the cerebel- 
lum, and the medulla oblongata. These are all contained within the 
skull bones, and are immediately covered by three membranes, called 
the dura mater, the arachnoid, and the pia mater. The dura mater is 
'a strong, fibrous membrane lying next to the skull-bones. The arach- 
noid is a serous membrane, lying next below, and the pia mater, which 
means pious mother, is a vascular membrane, lying next to the brain, 
dipping into it in places, and containing the vessels which bring to it 
all its nutrient materials. Hence its name. 

These membranes are all liable to be inflamed, — and so is the 
brain. 

Inflammation of the Dura Mater. 

The inflammation of this membrane does not often occur sponta- 
neously ; but it happens frequently from external injuries, as blows 
upon the head. 

After a blow upon the head which stuns him, a man may recover 
himself, and for some days remain in perfect health. Then he has 



DISEASES OF THE BRAIN AND NERVES. 153 

pain ill The head, is restless, cannot sleep, has a flushed face, red eyes, 
hot skin, hard pulse, rigor, nausea, vomiting, — ending with convul- 
sions and delirium. 

This disease is often caused by Vhat is called otitis^ or inflamma- 
tion of the internal ear. In such cases, inflammation will arise within 
the tympanum, causing intense earache; matter comes at length from 
the external ear, but the pain does not stop ; the patient shivers, be- 
comes drowsy, perhaps delirious, and finally sinks into stupor. The 
dura mater is inflamed. 

Treatiueiit — When the disease arises from inflammation in the 
ear, leeches are to be applied behind the ear, and blisters and other 
irritants afterwards. Other modes of treatment will be mentioned 
after the next two forms of disease. 

Inflammation of the Arachnoid and Pia Mater. 

Arachnitis, 

These two membranes are generally inflamed together. They 
are so intimately connected that each involves the other in its own 
troubles. 

Generally this is divided into three stages : 

The Irritative, characterized by wakefulness, irritable temper, re- 
pugnance to strong light, and contraction of the pupils. 

The Iiifliniimatoiy stage, known by transient pains in the head, 
alternating with similar ones in the bowels, increased restlessness and 
irritability, a quick and tense pulse, an expression of discontent on 
the face, the eye-brows knit and frowning, the eye-lids half closed, 
retching and vomiting, deep sighing, and torpid bowels. 

Tlie Depressing' Stag'e, in which the delirium is more continuous^, 
the countenance has a look of surprize and stupor, the pupils are 
contracted or dilated, the white of the eyes injected and red, the 
pupils rolled up during sleep, constant sleepiness, inattention to sur- 
rounding objects, torpidity of mind, gradually increasing until com- 
plete coma closes all the senses. 

The disease does not always exhibit all these symptoms, or come 
on in the regular way described. Sometimes the first thing noticed is 
a long-continued paroxysm of general convulsions. Again these con- 
vulsions will come on after violent pains in the head, and are at- 
tended with screaming. 

Inflammation of the Brain.— Brain Fever. 

Encephalitis. — Phrenitis. 

Acute and general inflammation of the brain and its membranes 
has two stages. 

The Stag-e of Excitement, in which there is intense and deep-seated 
pain in the head, extending over a large part of it, a feeling of tight- 
ness across the forehead, throbbing of the temporal arteries, a flushed 

20 



154 DISEASES OF THE BRAIN AND NERVES. 

face, injected eyes, looking wild and brilliant, contraction of the pupils, 
great shrinking from light and sound, violent delirium, want of sleep, 
general convulsions, a parched and dry skin, a quick and hard pulse, 
a white tongue, thirst, nausea a»d vomiting, and constipation of the 
bowels. 

The Sta^e of Collapse, in which there are indistinct mutterings, dull 
and perverted hearing and vision, double vision, the pupil from being 
contracted* expands largely and becomes motionless, twitchings of the 
muscles, tremors and palsy of some of the limbs, a ghastly and ca- 
daverous countenance, cold sweats, profound coma, and death. 

The disease will not show all these symptoms in any one case. It 
runs a rapid course, causing death, sometimes, in twelve or twenty- 
four hours ; or it may run two or three weeks. 

Treatment. — This should be energetic and administered early. 
The measures usually employed are blood-letting, purging, and the 
application of cold to the head. 

General Blood-letting. — This is much approved by many ; for my- 
self, I do not like it. Wet cups and leeching are about the extent to 
which 1 would ever carry the abstraction of blood in these diseases. 
These may sometimes be applied with advantage to the neck, and 
behind the ears. 

Cold Applications. — These, applied to the head, are of great im- 
portance. First, shave the head, and put on cloths wetted in water 
as cold as it can be made, changing them often; or, put powdered 
ice in a flexible bladder, and lay it upon the head, — taking care not 
to make it too heavy. 

Purging. — This, while the inflammation is in the active stage, 
should be thorough and energetic. To effect it, many use calomel 
and other forms of mercury. They are not needed. Croton oil is 
one of the best articles (31), or calacynth, gamboge, etc. (32), without 
the oil, or the compound powder of jalap. 

In the stage of collapse, if there is pallor of the countenance, a 
feeble and flying pulse, great debility and tremors, coldness of the 
extremities, etc., give wine and other stimulants. 

See that the bladder is emptied every day. 

The feet, in the early stage of the complaint, should be bathed in 
warm water, or mustard and water (242). Mustard draughts must 
also be put upon the feet. 

The tincture of veratrum, given in full doses, to bring down the 
pulse, and produce sweating, must not be omitted. 

Softening of the Brain. — RamolUssement. 

Inflammation of the brain, when it has run its course, sometimes 
leaves this organ, or portions of it, in a softened condition. The 
same mischief may happen to the brain from the blood-vessels which 
run to it being diseased, so as not to be able to carry blood for its 
proper nourishment. 



DISEASES OF THE BRAIN AND NERVES. 155 

SjTiiptoms. — The most remarkable symptom of this disease is the 
rigid contraction of the muscles which draw up the limbs ; the hand 
may be clenched and pressed against the shoulder, or the heel carried 
up to the hip. 

The other symptoms are various, — tingling and numbness in the 
ends of the fingers ; perverted vision, and sometimes blindness ; paral- 
ysis of one limb, or half the body ; difficulty of answering questions ; 
forgetfulness, making it difficult, at times, for the patient to remember 
his own name. 

Suppuration and Abscess of the Brain. 

When a diseased brain is examined after death, sometimes matter 
is found mixed in with the softened portion. This shows that suppu- 
ration took place. At other times, the matter is found in a cavity, 
which shows that an abscess had formed during life. 

The symptoms of these mischiefs are convulsions in the earlier 
stages, and palsy in the latter. 

Induration of the Brain. 

Instead of softening the brain, inflammation sometimes does the 
very opposite, — it hardens it, — producing a change something like 
that which happens to white of egg when dipped in hot water. 

Convulsions appear as the result of this change, as in suppuration 
and abscess ; palsy much more seldom. 

Tumors of the Brain. 

Tumors infect the brain, occasionally, — growing around it, on all 
sides, pressing themselves into its substance, and causing many dis- 
turbances. Cancers and hydatids are found there. The signs which 
these irritating bodies produce, are like those of other diseases of the 
brain, and therefore cannot be distinguished during life. 

Delirium Tremens.— Drunkards' Delirium. 
Mania a Potu» 

This is often mistaken for brain fever ; but it is quite a different 
disease. It is not the result of inflammation of the brain, but of 
irritation. It is important to distinguish it from inflammation, be- 
cause the remedies which are employed for that would be injurious 
if used for this. 

The Symptoms are incessant talking, fidgeting with the hands, trem- 
bling of the limbs, a rapid pulse, profuse sweating, utter sleeplessness, 
and a mingling of the real with the imaginary in the busy talk. The 
patient is apt to think some one is about to do him a great injury, 
yet is unwilling to be alone. His face is pale and sallow (sometimes 
red and flushed), his eye is rolling, quick and expressive, his speech 



156 DISEASES OF THE BRAIN AND NERVES. 

stuttering and inarticulate, — bodily and mentally, he is busy day and 
night, and can with difficulty be confined to his bed or room. As the 
disease advances, and he has been long without sleep, he imagines 
vermin to be crawling upon his scalp and body; troops of rats run 
across his bed, or look at him out of the wall ; giant boxers confront 
him, and he squares off* for a round at fisticuffs ; animals, figures of 
all shapes, and horrible monsters, frighten his imagination ; devils 
laugh at him, and dance before him. In long and sleepless hours, he 
talivs and chatters with these spectral phantoms, — now beckoning 
them, now shrinking from them, till he wears out and sinks from ex- 
haustion. This is a disease of drunkards and opium eaters. The 
attack generally occurs in consequence of the Withdrawal for three or 
four days of the accustomed stimulus. 

Treatment. — Opium and its preparations are the sovereign remedy. 
Give one-third of a grain of morphia ; if this does not quiet the 
patient, give thirty drops of laudanum every two hours, till sleep is 
produced. Sleep will cure him, and nothing else will. A draught or 
two of his accustomed drink, brandy, gin, or whatever it may be, will 

' also generally dispose him to sleep. 

i Recently, a very effectual remedy has been found in the use of 

tepid baths, prolonged from four to ten hours, in connection with 
cold applications to the head. In connection with this, small doses 
of opium are required ; but the treatment may yet prove to be very 
valuable by enabling us to dispense with excessive doses of opium. 

Enlargement of the Brain. — Hypertrophy, 

This is chiefly a disease of childhood. It consists in an unnatural 
growth of the brain. Sometimes the skull grows with it, and there 
may not be any, or only slight, symptoms of disease. 

The complaint is sometimes congenital, — the child being born 
with a head far above the natural standard of size. Sometimes a 
child's head, from this disease, will reach the size of an adult's, by the 
time it is five or six years old. This is not necessarily a disease^ 
though children that suffer from it are very apt to die finally of some 
affection of the brain. 

Sjiiiptoms. — Dulness of intellect, indifference to external objects, 
great irritability of temper, inordinate appetite, giddiness, and an ha- 
bitual headache, which at times is very severe. In addition to these, 
there are, at times, convulsions, epileptic fits, and idiocy. There is a 
peculiar projection of the parietal bones, which serves well to distin- 
guish this disease from acute hydrocephalus. 

• 

Treatment. — As far as possible, suspend and repress all exercise of 
the mind. Take the child from school as soon as the disease is dis- 
covered, and put it to the most active muscular exercise in the open 
air. The moment there is any excitement of the brain, or heat on 
the top of the head, apply cold water, ice, or cold evaporating lotions. 
If, J^s the child grows up, the signs of mischief increase, the diet must 



DISEASES OF THE BRAIN AND NERVES. 157 

be simple, nnd carefully regulated. Bread and milk only is some- 
times advisable. 



Shrinking of the Brain. — Atrophy. 

This is a disease in which the volume of the brain is diminished. 
There are two forms of it; one is congenital, the brain not being 
properly developed at birth ; the other occurs in consequence of dis- 
ease either in the membranes or the arteries. The symptoms are not 
distinguishable during life from those of other brain affections, and 
therefore it can only be treated according to general principles. 

Water in the Head. — Acute Hydrocephalus. 

This, Rke enlargement of the brain, is likewise a disease of child- 
hood, and often attacks scrofulous children. 

Being an inflammatory disease, it is important to have early notice 
of its existence, and, if possible, to be aware of its approach; which 
we may be, frequently, by observing the ioWowmg premonitory 

Symptoms ; namely, a disturbance of the disgestive functions, indi- 
cated by a capricious appetite, — the food at one time being disliked, 
at another devoured greedily; a foul tongue, offensive breath, enlarged 
and sometimes tender belly, torpid bowels, stools light-colored from 
having no bile, or dark from vitiated bile, fetid, sour-smelling, slimy 
and lumpy. The child loses its healthy look, and grows paler and 
thinner. Its customary spirit and activity are gone ; it is heavy, lan- 
guid, dejected ; it is fretful, irritable, uneasy ; and sometimes is a 
little tottering in its gait. 

After these warning symptoms, the disease may begin in one of 
three ways : 

The pains in the head become more severe and frequent, and are 
sharp and shooting, causing the little patient to wake and shriek out. 
As the drowsy state advances, the shrieking gives place to moaning. 
Beside these symptoms, there are stiffness in the back of the neck, 
pain in the limbs, great tenderness of the scalp, vomiting, sighing, 
intolerance of light, knitting of the brows, increased disturbance of 
stomach and bowels. This stage may last ten to fourteen jd^ys, the 
child growing more weak and peevish. 

Another form of attack is marked by acute pain in the head and 
high fever, convulsions, flushed face, brilliant eyes, intolerance of light 
and sound, pain and tenderness in the belly, stupor, great irritability 
of stomach, causing retching and vomiting upon every attempt to sit 
up in bed. 

The third mode of attack is very insidious, — the early symptoms 
being mild and hardly noticeable, or not even occurring at all. In 
such case, the convulsions or palsy come suddenly, without notice, 
bringing swift and unexpected destruction. This has sometimes been 
called water-stroke. 



t 



158 DISEASES OF THE BRAIN AND NERVES. 

The First Stag'e is the period of increased sensibility and excite- 
ment, caused by inflammation, in which the pulse is quick and irreg- 
ular. 

The Second Stage is one of diminished sensibility, or lethargy, dur- 
ing which water is effused upon the brain, and the pulse is slow. 

The Third Period is one of palsy and convulsions, with squinting 
of the eyes, rolling of the head, stupor, and a rapid, thread-like pulse. 

Treatment, — In the first or inflammatory stage, purging is very 
important, and it must be continued for three or four days. Scam- 
mony and croton oil (33) may be chosen for this purpose. Apply 
cold water, ice, etc., to the head. 

In the second stage, put blisters upon the back of the neck, and 
one upon the bowels if they are very tender. 

In the third stage, effusion having taken place, use the warm bath, 
or the vapor bath, — also digitalis, squills, and iodide of potassium, 
(144) (128) (302) (130). 

Confine the child to a darkened room, of moderate temperature, — 
excluding all noise and causes of excitement, and let him lie upon a 
hair mattress, with his head somewhat elevated. 

Diet, — Gruel only during the stage of excitement, — during that 
of collapse, it should be nourishing, but mild and easy of digestion, 
as beef tea, plain chicken or mutton broth, and animal jellies. At 
the same time, support the patient by the cautious use of the aro- 
matic spirit of ammonia, ten drops every four hours, valerian, wine 
whey, and infusion of gentian, columbo, or quassia, (64) (66). 

Dropsy of the Brain. — Chronic Hydrocephalus, 

Acute hydrocephalus is an inflammation; chronic hydrocephalus, 
now to be considered, is a dropsy. It often begins before birth. It con- 
sists in the accumulation of enormous quantities of water within the 
brain, sometimes within its ventricles, at other times, upon its surface. 
When it occurs soon after birth, it advances slowly, and impercepti- 
bly, — the enlargement of the head being the first thing noticed. 

The skull being tender in infancy, it separates at the fontanelles, as 
the fluid accumulates, and the head, at times, attains an enormous 
size, — so great that the child cannot carry it upright, but lets it droop 
laterally upon the shoulder, or forward upon the breast. 

As the disease advances, the senses become blunted, the child is 
deaf or blind, the intellect is weakened, perhaps idiocy appears, the 
flesh and strength pass away, convulsions and paralysis come in their 
turn, and a stupor is apt to occur which ends in death. 

Treatment, — The remedies may be external, or internal, or both. 

Internal Remedies. — These should be purgatives (33) (31), or di- 
uretics and alteratives (302) (145) (144). 

External Remedies, — Apply an ointment of the iodide oi potas- 
sium to the scalp every night (185). A tight bandage applied over 



DISEASES OF THE BRAIN AND NERVES 



159 



the whole head will sometimes have a favorable effect. Another ex- 
pedient is to puncture the skull and draw off the water. Tapping 
The brain has effected a cure in many cases, and perhaps promises the 
most relief of any remedy we have. 

Diseases of the Spinal Cord. 

Fig. SI. There are few diseases more interesting, as a study, 

than those w^hich affect the nervous cord which runs 
through the centre of the back-bone. This cord is a 
continuation, an appendage or tail of the brain. (See 
Figure 81.) It is the seat and centre of certain ner- 
vous functions, called reflex^ by which so many move- 
ments take place which are not under the control of the 
will. 

In order that w^e may feel what takes place in any 
part of the body or limbs, and that the will may have 
power to move such part, it is necessary that nervous 
matter should be continuous and unbroken between the 
part in question and the brain. 

If the spinal cord be cut, broken, or crushed at any 
point, all those parts which receive nerves from below 
the injury, lose their power of motion and their feel- 
ing. When the injury is in the upper part of the cord, 
the breathing and the circulation will stop, and death 
is the immediate consequence. If the middle portion 
of the cord be the seat of the injury, the bowels and 
other organs may lose their motion and feeling ; if the 
lower portion, then the lower limbs only will be the 
sufferers. 

Disease or injury in the upper part of the cord is 
therefore much more dangerous than the same thing 
occurring in the lower. 

Inflammation of the Spinal Cord. 

The membranes which surround the cord may be inflamed just as 
those are which enclose the brain ; but as the cavity running through 
the spine is quite small, there cannot very well be inflammation of 
the membranes without its involving the cord at the same time. 

Symptoms. — Pains, often intense, running along the spine, extend- 
ing out into the limbs, and made worse by motion. They are similar, 
in some respects, to rheumatic pains. There is rigid contraction, and 
sometimes violent spasms of the muscles of the back and neck, — so 
great, at times, as too bend the body back into the shape of a hoop ; 
also a feeling of constriction in various parts, as if they were girt by 
a tight string ; a sense of suffocation ; retention of urine ; a most 
obstinate constipation ; and frequent chills or rigors. The pain which 
is felt along the cord is aggravated by rapping upon the spine, but 
not by pressure. 



ICO DISEASES OF THE BRAIN AND NERVES. 

The above symptoms are supposed to be the result of inflammation 
predominating in the membranes. When its seat is more particularly 
in the substance of the cord, the symptoms are, — convulsive affec- 
tions of the head and face, inarticulate speech, loss of voice, squint- 
ing, and difficulty of swallowing, if the extreme upper part of the 
cord is inflamed ; if the disease be slightly lower, difficulty of breath- 
ing, irregular action of the heart, and tightness of the chest ; if lower 
still, vomiting, pain in the belly, sensation of a cord tied round the 
abdomen, pain and heat in passing water, retention of the urine, ina- 
bility to retain the urine, desire to go to stool, or involuntary stools. 

Spasm and stiffiiess, then, are the results of inflammation of the 
membranes ; convulsions and palsy, of the same aifection of the 
cord. 

Treatment. — When the inflammation is acute, apply a few leeches 
or wet cups along the sides of the spine. In chronic inflammation, 
powerful friction, or mustard draughts, stimulating liniments (190), 
or plasters, will generally answer the purpose. 

Apoplexy. 

Apoplexy is that condition in which all the functions of animal 
life are suddenly stopped, except the pulse and the breathing; — in 
which there is neither thought, nor feeling, nor voluntary motion ; in 
which the person falls down suddenly, and lies as if in a deep sleep. 

Modes of Attack. — There are at least three ways in which this 
terrible disease may make its assault. 

The First Form of attack is a sudden falling down into a state of 
insensibility and apparently profound sleep, — the face being generally 
flushed, the breathing stertorous or snoring, the pulse full and not 
frequent, with occasional convulsions. 

From this mode of attack some die immediately, others get entirely 
well, and others get off with the exception of paralysis on one side, 
or the loss of speech, or some one of the senses. 

The Second mode of attack begins with sudden pain in the head. 
The patient becomes pale, faint, sick, and vomits, — has a cold skin 
and feeble pulse, and occasionally some convulsions. He may fall 
down, or be only a little confused, but will soon recover from all the 
symptoms, except the headache, — this will continue, and the patient 
will sooner or later become heavy, forgetful, unable to connect ideas, 
and finally sink into insensibility, from which he never rises. 

This mode of invasion, though not appearing so frightful as the 
first, is of much more serious import. 

In the Tliird form of attack there is sudden loss of power on one 
side of the body, and also of speech, but not of consciousness. The 
patient retains his mind, and answers questions either by words or 
signs. This may be called paralytic apoplexy. The patient may 
either die soon, or get well, or live for years, with imperfect speech, 
or a leg dragging after him, or an arm hanging useless at his side. 



DISEASES OF THE ET^AIX AND KERVES. 161 

The Persons Attiieked are apt to have large heads, red faces, short 
and thick necks, and a short, stout, square build, though it occurs 
often among those who are thin, pale, and tall. The tendency to it 
increases in advanced life. 

The Forenumers of apoplexy are headache, vertigo, slight attacks 
of palsy, double vision or seeing two objects when there is but one, 
faltering speech, inability to remember certain words, sometimes a 
sudden forgetfulness of one's own name, a frequent losing of the 
thread of ideas attempted to be pursued, and occasionally an unac- 
countable dread, for which no reason cf«i be given. 

ExTitiiio' Causes. — Whatever hurries the circulation of the blood, 
as strong bodily exercise, is an exciting cause. So are all those things 
which cause the blood to flow towards the head, as coughing, sneez- 
ing, laughing and crying, straining at stool when costive, lifting heavy 
weights, singing, and playing on wind instruments. To these may 
be added, exposure to the sun, the bad air of crowded rooms, holding 
the head down, or turning it around to look backward, tight cravats 
worn about the neck, and exposure to severe cold. 

Treatment. — If the patient have the appearance of suffering from 
fulness of blood in the head, as evinced by redness and turgescence 
of the face, and throbbing of the temporal arteries, and if the pulse 
be full and hard, feeling like a tense vibrating rope under the finger, 
place him in a half-recumbent posture, with his head raised ; loosen 
his clothes, particularly his neck-cloth and shirt collar, and whatever 
may press upon the neck, and then as quickly as possible apply cold 
wet cloths to his head, changing them often. Ice is still better, if it 
may be had. Apply wet cups to the nape of the neck, and mustard 
draughts to the soles of the feet, — at the same time applying tight 
ligatures around the limbs, to prevent the blood from returning rap- 
idly in the veins. The ligatures should be gradually removed when 
the patient recovers his consciousness. Also administer a stimulating, 
purgative injection (246), and place two drops of croton oil, rubbed 
up with a little pulverized loaf sugar, far back upon the tongue. Re- 
peat the injection every fifteen minutes, till the bowels are thoroughly 
moved. 

If the patient be old, and the pulse small and feeble, with no ful- 
ness or beating of the temporal arteries, or swelling of the veins of 
the neck and forehead, the countenance being pinched, and the skin 
bloodless and cool, the cupping, purging, and applying the ligature 
must be omitted. In this case it will be better to apply warm flan- 
nels and hot bricks to the surface, and administer ammonia and 
camphor (283) (135) internally. 

To prevent future attacks, gentle tonics should be used, and the 
skin should be kept healthy by daily bathing and friction. The bow- 
els must not be permitted to become costive. The diet should be 
light, chiefly vegetable, and almost entirely so in hot weather. The 
food should be well chewed. The mind should be kept cheerful and 
hopeful, and free from great excitement. The sexual passion should 
be restrained, and very rarely indulged. Intoxicating drinks should be 

21 



162 DISEASES OF THE BRAIN AND NERVES. 

abandoned, if used, and all tight cravats be discarded from the neck. 
Direct rays of the hot sun in summer should be carefully shunned. 
No food should be taken for three hours before retiring, and a mat- 
tress only, of some degree of hardness, should be slept upon, — the 
head being always well elevated. To these precautions, T would add, 
dipping the feet every night, before retiring, in cold water; and, if 
any tendency to cold feet be experienced, dusting pulverized cayenne 
in the bottoms of the stockings. 

Sunstrokq. — Coup Be Soleil. 

This is much like apoplexy ; in fact, it is a kind of apoplexy. It 
occurs in warm climates, or in very hot days in temperate regions, by 
exposure to the sun. 

It begins by headache, thirst, dizziness, and sometimes difficult 
breathing and bilious vomiting. The patient drops down senseless, 
as in apoplexy, and unless immediate relief is obtained, soon dies. 

Treatment, — Take the patient immediately into the shade, and 
employ about the same remedies as for apoplexy. 

Palsy.— Paralysis. 

Palsy is a loss of the power of voluntary motion and feeling, one 
or both coming on, sometimes gradually, but more often suddenly, 
and exteliding at one time to a part, at another time to the whole 
body. It is a kind of station-house on the way to apoplexy, where 
passengers stop, not merely to stay over night, but to rest many days, 
or even years. 

A great injury inflicted upon the brain, either by pressure, or other 
cause, will induce a complete loss of motion and feeling, and this ex- 
tending to the whole structure, brings likewise a loss of conscious- 
ness, which is apoplexy. A smaller degree of pressure, or a less 
injury upon the same brain, would occasion a loss of motion only, or, 
if a loss of feeling were experienced also, it would only extend to a 
part of the body, and consciousness would remain. This would be 
palsy. The disease is like apoplexy in kind, but stops short of it in 
degree. 

Hemiphlegia. 

When palsy affects an entire half of the body, dividing it through 
the centre of the face, neck, body, etc., from head to foot, it is called 
hemiphlegia. It is more nearly allied to apoplexy than any other 
form of the disease, and is generally ushered in by pretty well-marked 
apoplectic symptoms. 

Symptoms. — Sometimes there are no premonitory symptoms ; but 
often before the attack there are flushed face, swelling of the veins 
about the head and neck, vertigo, a sense of fulness, weight, and 
sometimes pain in the head, ringing in the ears, drowsiness, indistinct 



DISEASES OF THE BRAIN AND NERVES. 163 

articulation of words, or even loss of speech, confusion of mind, loss 
of memory, and change of disposition, — amiable persons being made 
sullen and peevish, and irritable ones mild and simpering. After the 
attack, the countenance generally acquires a vague expression ; the 
mouth is drawn to one side ; the lower lip on the palsied side hangs 
down, and the spittle dribbles away. The speech is altered, and the 
mind is generally impaired. 

In some instances, the patient recovers in a longer or shorter time ; 
in others, little or no improvement takes place, and the patient, after 
remaining helpless, often for a long time, dies either from gradual 
exhaustion, or suddenly from apoplexy. 

Paraphlegia. 

This form of palsy divides the body transversely^ at the hips, and 
confines itself to the lower extremities, and to the parts about the 
pelvis. 

Symptoms, — When it arises from affections of the brain, it is at- 
tended by pain in the head, giddiness, drowsiness, dimness of sight, 
and impaired memory. Numbness is sometimes felt in the upper 
extremities as a forerunner of this form of palsy. At first there is a 
slight stiffness and awkwardness of the motions of the legs, which 
continue to increase till a cane is needed to balance the body and 
make it steady. From a paralysis of the neck of the bladder, the 
stream of urine grows more feeble, and finally dribbles away involun- 
tarily. The bowels are for a time costive, but when the circular 
muscle which closes the fundament becomes palsied, the feces pass 
without consent of the will. 

When disease of the spinal cord is the cause of the complaint, it 
is apt to come on gradually ; languor and weakness are felt in the 
knees, the legs are not easily directed in w^alking, — being thrown 
across each other, causing tripping and stumbling. By degrees the 
loss of power increases in the thighs and legs, until at length the 
whole lower extremities become palsied and useless. 

Local Palsy. 

Palsy is called local when it is confined to a single limb, or muscle, 
or locality. One of these forms is called facial palsy. It affects 
one half of the face only, and is a good specimen of these affections. 
It removes all power of expression from one half of the face, and 
leaves the features still, blank, and unmeaning. With the affected 
side of the face, the patient cannot laugh, or weep, or frown, or ex- 
press any feeling or emotion, while the features of the other side are 
in full play. Among the ignorant, who do not comprehend the extent 
of the evil, the drollness of the expression excites laughter. 



164 DISEASES OF THE BRAIN AND NERVES. 

Shaking Palsy. 
The nature of this form of palsy is well expressed by its name. 

Symptoms. — The first symptom of this complaint is a weakness 
and tremor of the head or hand. In about a year the other hand, or 
the lower extremities become affected ; and the patient begins to lose 
his balance in walking. Then the trembling becomes perpetual ; no 
limb or part remains still. Reading and writing are no longer possi- 
ble, and the hand cannot even carry the food to the mouth. The 
balance cannot be maintained in walking ; there is a tendency to fall 
forwards, and to avoid it, the patient is obliged to run or move 
quicker, and upon the toes. 

At a later period, the tremor continues during sleep ; there is in- 
creased weakness ; the body is bent forward, the speech becomes 
indistinct, swallowing difficult, and the bowels torpid. At last, the 
urine and feces pass involuntarily, and delirium and coma bring life 
to a close. 

Lead Palsy. 

In this disease the muscles of the forearm are palsied, so that the 
wrists " drop," as it is said, and the hands hang down when the arms 
are stretched out. It is caused by the gradual introduction of lead 
into the system. It is a disease, therefore, peculiar to painters, — 
particularly those who use carbonate of lead, or white lead, as it is 
called. It is generally the sequel of painter's colic. 

Causes. — Hemiphlegia and paraphlegia, are caused by pressure 
upon the brain, by the effusion upon it of blood or water, by a tumor, 
by mechanical injuries, by the striking in of eruptions, and by intem- 
perance in eating and drinking. Paraphlegia often results from dis- 
ease or injury of the spinal marrow. 

Treatment. — A sudden and severe attack of palsy requires the 
same treatment as apoplexy. When the bowels are obstinately con- 
stipated, they must be purged by scammony and croton oil (31) (32,) 
and by injections (246). 

When all the symptoms of determination of blood to the head 
have disappeared, and the disease has become strictly chronic, ex- 
citing remedies must be employed, as frictions, stimulating liniments, 
blisters, stimulating baths, cold afiusion, and electricity. Among the 
internal remedies, strychnine has the best reputation (85) (86). The 
tincture of the poison oak is well recommended (284). An altera- 
tive (145) should likewise be used. 

Apply counter-irritants along the track of the spine, such as blis- 
ters, the moxa, the compound tar plaster, and the pitch plaster. 

At first the diet should be light ; but after the more active symp- 
toms have disappeared, it should be nutritious, and sometimes stimu- 
lating. Flannel under-clothes should always be worn next the skin. 



DISEASES OF THE BRAIN AND NERVES. 165 

For kad palsy, the best remedies are iodide of potassium, or sul- 
phuret of potassium. The dose of either of these is from three to ten 
grains, three times a day, dissolved in water, one ounce of the salt to 
six ounces of water, and taken in simple syrup. The affected limb 
should also be soaked an hour each day in a gallon of water, with 
half an ounce of sulphuret of potassium dissolved in it. 

Hydrophobia. — Rabies. 

The bite of the mad dog, or mad wolf, or other hydrophobic ani- 
mal, is the most dangerous of all poisoned wounds, because it is apt 
to be followed by a disease for which there is no certain remedy. 
Fortunately, the human subj(?et is not as susceptible to the effects of 
the poison as some of the lower animals ; for only about one-tenth 
of those bitten are attacked by hydrophobia. 

Symptoms. — The interval between the bite and the appearance of 
the disease, varies from twelve days to two months. The wound 
heals like any other bite of a similar animal. After a time, the scar 
begins to have darting, lancinating pains, which, if it be a limb that 
was bitten, run up towards the body. Sometimes it feels cold, or 
stiff, or numb, or becomes red, swelled, or livid, and occasionally 
breaks open, and discharges matter. The patient feels a strange 
anxiety, is depressed in spirit, has an occasional chill, and disturbed 
sleep, and spasmodic twitches. The pulse is above its natural state, 
both in quickness and strength, and the nervous system is very im- 
pressible. The senses are all more acute ; trifling noises produce 
agitation, and the eyes are so disturbed by the light that the patient 
sometimes hides himself in a dark place. The appetite is lost. This 
is the first stage. 

Thirst now appears, and he attempts to drink. But the moment 
water approaches his mouth, a spasmodic shudder comes over him ; 
he pushes it back with horror ; the awful fact of his condition flashes 
upon him ; and he cries out, " What I have dreaded has come upon 
me." 

Thenceforward he can swallow no fluids ; complains of pain and 
stiffness about his neck ; is thrown into convulsions by the sight of 
water, or even the sound of liquids agitated in a vessel, or by a breath 
of air blowing upon him, by a bright light, or the glare of a mirror. 
His throat is full of a viscid, glairy matter, which he continually tries 
to clear away. Thus, between convulsions, in which he struggles, 
and sometimes strives to bite his attendants, and comparative still- 
ness, during which he suffers great depression of spirits, he passes 
three or four days, and then dies either in a spasm, or from exhaus- 
tion.- 

Treatment — Cut off the bitten part, or apply dry cupping, or suc- 
tion, at once. Also the caustic potash. The internal remedies here- 
tofore employed have had little success. Perhaps nothing now known 
promises more than to keep the patient, for a long time, under the 
influence of chloroform or ether. The tincture of scullcap, in two or 



166 DISEASES OF TPIE BRAIN AND NERVES. 

three dram doses, will allay the nervous agitation, and is always 
worth using. It has been proposed to clear the throat of the tough 
mucus by cauterizing it with a strong solution of nitrate of silver 
(219), applied with a shower syringe. The remedy is worthy of a trial. 

Some of the Western physicians declare the red chickweed, or 
scarlet pimpernell, to be an absolute remedy for this disease, and cite 
some quite remarkable cases of its success. Four ounces of this 
plant, in the dried state, are directed to be boiled in two quarts of 
strong beer or ale, until the liquid is reduced one half. The liquid is 
to be pressed out and strained, and two drams of laudanum added to 
it. The dose for a grown person is a wine-glassful every morning, 
for three mornings. A larger dose is required if the disease have 
begun to show itself; and if the case be fully developed, the whole 
may be taken in a day. The wound is to be bathed with the same 
decoction. The medicine, it is said, produces profuse sweating. It 
is worth a trial. 

Considerable has been said of late of a remedy used in some parts 
of Europe, and said to be effectual. It is the " golden cenotides " 
(cetonia aurata), or common rose beetle, found in large quantities on 
all rose trees. A similar insect is said to infest the geranium plant. 
When collected, they are dried and powdered ; and given in this 
form, relieve excitement (so it is said) of the brain and nervies, and 
throw the patient into a sound sleep. 

Muscular and Nervous Derangements from Wounds. 

In some persons, a very small local injury will produce violent dis- 
turbance of the nervous system. Some will faint and be thrown into 
convulsions and vomiting from causes scarcely greater than the prick 
of a needle ; and, before Morton gave the world the boon of ether, it 
was not very uncommon for persons to die under the knife of the 
surgeon. One of the most serious disturbances from wounds, of a 
nervous and muscular character, is 

Locked Jaw. — Tetanus. 

This is spasmodic contraction, with rigidity, or stiffness, of the 
voluntary muscles. Sometimes this rigidity is partial, at other times, 
universal throughout the system. 

Tetanus is produced by two causes, exposure to cold (idiopathic), 
and bodily injuries^ particularly the injury of a nerve (traumatic 
tetanus). This last is the most frequent, — perhaps the only form of 
the complaint. 

The Symptoms are long-continued, violent and painful contraction 
or cramp of the voluntary muscles. At first there is difficulty and 
uneasiness in turning the head, with inability to open the mouth 
easily, — then the jaws close gradually, but with great firmness ; swal- 
lowing now becomes difficult, and a pain, starting from the breast- 
bone, pierces through to the back, — probably caused by cramp of the 



DISEASES OF THE BRAIN AND NERVES. 



167 



diaphragm or midriff. The cramps now extend to the muscles of the 
body, the limbs, the face, the tongue, etc., which continue in a state of 
rigid spasm, — being swelled and hard in the centre, — till the disease 
yields, or the patient dies. At times the abdominal muscles are so 
tense ag to make the belly as hard as a board. Occasionally the 
patient is drawn backward into the shape of a hoop, so as to rest on 
his head and heels [epistliotonos) ; at other times he is drawn forward 
in the shape of a ball (emprosthotonos). All the contractions are at- 
tended with intense pain. It is the racking of the entire body with 
cramps like those which sometimes attack the calf of the leg. So 
violent are the contractions that the teeth are sometimes broken by 
them, and the tongue is often badly bitten. In the mean time, the 
appearance of the sufferer is frightful. The forehead is wrinkled, the 
brow knit, the eye-balls motionless and staring, the nostrils spread, 
the corners of the mouth drawn back, the set teeth exposed, and all 
the features fixed in a ghastly grin. 

Treatment. — The only known remedies for this disease are chloro- 
form and ether, taken either into the stomach, or by inhalation, in 
quantities sufficient to control the spasm, and to be pursued as long 
as they continue to occur. The costiveness must be removed by one 
or two drops of croton oil, administered in a spoonful of gruel. 

Epilepsy.— Epileptic Fits. 

This disease has been sometimes called the falling sickness^ but 
generally passes under the more vague title of fits. 

Symptoms. — The disease is characterized by a temporary loss of 
consciousness, strong spasms, and intervals between the fits. The 
attack is sudden, generally without warning, and attended with a loud 
ccy, when the patient falls down, is senseless and convulsed, strug- 
gles violently, breathes with embarrassment, has a turgid and livid 
face, foams at the mouth, bites his tongue, has a choking in the wind- 
pipe, and appears to be at the point of death. Presently, in from five 
minutes to half an hour, and by degrees, these symptoms diminish, 
and at length cease ; and the patient falls into an apparent sleep. In 
a short time more he recovers, and is apparently well. These attacks 
come again and again, and at irregular intervals. 

This is the worst form of the disease ; there is another class of 
cases in which the symptoms are much lighter, — there being no tur- 
gescence of the face, no foaming at the mouth, no cry, no convul- 
sions ; but merely a sudden and brief suspension of consciousness, a 
fixed gaze, a feefing of confusion, or a totter, from all of which the 
recovery is speedy. 

Causes. — These are numerous, — as worms, disturbance from indi- 
gestible food in the stomach and bowels, difficult teeth-cutting, ner- 
vous irritation, either direct or by sympathy, sexual excesses and 
masturbation, disease or injury of the brain or spinal marrow, gall 
stones in the excretory duct of the liver, stone or gravel in the kid- 



168 DISEASES OF THE BRAIN AND NERVES. 

neys and bladder, fright, distress of mind, passion, great loss of blood, 
and many others. 

Treatment. — But little can be done during the fit, except to protect 
the patient from being injured by the violence of the convulsions. 
To do this, place a piece of leather, cork, or other substance not too 
hard, between the back teeth to prevent the tongue from being bitten. 
Remove the neckcloth, and unbutton the shirt collar. If the stomach 
and bowels are suspected to be overloaded, give an injection (246). 

The treatment during the intervals, must depend on the cause of 
the disease. If worms be the cause, expel them ; if the attacks be 
excited by difficult teething, lance the gums ; if by uterine disturb- 
ances, search out the nature, and give the treatment recommended 
under the proper head ; if masturbation, command its entire discon- 
tinuance as the only hope of relief; if the complaint arise from in- 
digestible food, great attention must be given to the diet and general 
health. 

In all cases, indeed, the diet should be carefully regulated, being 
light, nutritious, and easy of digestion. The sleep should be taken 
at regular hours, and daily exercise in the open air be insisted upon. 
The bowels must be kept regular, by the food, if possible ; if not, by 
mild laxatives. Apply along the spinal column 195, once a day, 
rubbing it well in ; also, now and then, mustard poultices. 

In addition to these remedies, give pills of iron and quinine (72), 
one after each meal, — also oxide of zinc (270), which is one of our 
very best remedies. Of the pills, one should be taken three times a 
day. 

We can seldom go amiss in giving medicine calculated to relieve 
nervous irritation, and to build up the general system. For this pur- 
pose, the valerianate of quinine, and the extract of black cohosh (79) 
are w^ell adapted. Citrate of iron and strychnine (316), is a very 
valuable remedy. 

It is said that a black silk handkerchief thrown over the face of a 
person in a fit, will immediately bring them out of it. It is an ex- 
periment easily tried ; and having seen it in a respectable medical 
journal. I give it for what it is worth. 

Catalepsy.— Trance.— Ecstasy. 

Cataleptic fits are simply what is know^n to all the world under 
the name of trance ; and ecstasy is a modification of the same ner- 
vous disorder. It is a state in which the mind becomes so intensely 
absorbed in something outside of its earthly tenement, that it with- 
draws all control over the body, and all apparent connection with it, 
— leaving it as if dead. There is a very light ticking of the heart, 
just perceptible to a cultivated ear, but the breast does not rise and 
fall with breathing, the features are all inexpressive and still, the eyes 
are wide open and motionless, apparently staring after the departed 
intellect; and the body and limbs are entirely passive, — remaining 
unmoved where they are placed by others, however tiresome and 
uncomfortable the position. In a word, a person in catalepsy is, in 



DISEASES OF THE BRAIN xVND NERVES. 169 

appearance, like a marble statue, or like a human body suddenly 
turned to stone, or, like Lot's wife, to a pillar of salt. There is as 
little feeling, or thought, or consciousness, as if the bowl had been in- 
stantaneously broken at the cistern, and the apparent death were real. 

It is a peculiarity in this disease that the patient, on recovery from 
a fit, takes up the thread of conscious life just where it was broken by 
the attack. Thus, if she were lifting a cup of water to the mouth, 
she would hold it steadily, with the mouth open, till the return of 
consciousness, and then place it to the lips, as if no interruption had 
occurred ; or, if conversing, and in the midst of a sentence, the unfin- 
ished words would be uttered at the end of the fit, even though it 
should last many days. 

Persons in a cataleptic fit have much the appearance of one in the 
mesmeric state ; and the statue-like position in which an attack fixes 
a patient, reminds one of the manner in which the psychologists, so 
called, will arrest a man under their influence, and make him immov- 
able, with one foot raised in the act of stepping. 

The disease attacks females much more often than males. 

The premonitory symptoms are much like those of epilepsy, and 
the treatment should be about the same. 

Saint Vitus's Dance. — Chorea, 

This disease is chiefly confined to children and youth between the 
ages of eight and fourteen. But few cases occur after puberty. 

Symptoms. — The complaint affects mostly the muscles and the 
limbs. It excites curious antics, — such as we should suppose would 
occur if a part of the muscles of voluntary motion had hatched a 
mimic rebellion, broken away from the control of the will, and in 
sheer mischief and wantonness, were tripping their fellow muscles, 
and playing tricks with the patient. A few of the muscles of the 
face or limbs begin their mischievous pranks by slight twitches, which, 
by degrees, become more energetic, and spread to other parts. The 
face is twisted into all kinds of ridiculous contortions, as if the 
patient were making mouths at somebody. The hands and arms do 
not remain in one position for a moment. In attempting to carry 
food to the mouth, the hand goes part way, and is jerked back, starts 
again, and darts to one side, then to the other, then mouthward 
again ; and each movement is so quick, and nervous, and darting, and 
diddling, that ten to one the food drops into the lap. If the attempt 
be made to run out the tongue, it is snatched back with the quick- 
ness of a serpent's, and the jaws snap together like a fly-trap. The 
lower limbs are in a state of perpetual diddle ; the feet shuffle with 
wonderful diligence upon the floor, as if inspired with a ceaseless 
desire to dance. 

It is supposed by some that the disease consists in a partial palsy 
of a part of the muscles. The will in that case not being able to 
control the palsied muscles, when it commands the others to move, 
their action is not balanced, and they twitch the face and limbs into 
all the capricious and fantastic shapes we witness. 

22 



170 DISEASES OF THE BRAIX AND NERVES. 

Others, and probably with more truth, hold that the seat of the 
disease is in the cerebellum or little brain. It is supposed to be one 
of the functions of this organ to preside over and regulate the loco- 
motion, — that it holds the office of chief engineer, and that its duties 
are to keep the muscles in subjection to the will. The combined and 
consenting action of several muscles is needed for every movement. 
It is the business of the cerebellum to maintain this oneness of pur- 
pose and action — to see that no muscle flinches so as to disturb the 
harmony of the movement. When the cerebelluni is diseased, all is 
confusion, — just as the locomotive runs from the track when the en- 
gineer is smitten with palsy. 

The disease is not dangerous, but when it continues for many 
years, it is apt to weaken the mind, and it sometimes very nearly 
destroys it. 

Causes. — Whatever excites and weakens the nervous system, as 
powerful emotions of the mind, overworking the mind, reading excit- 
ing novels, eating too much meat, fright, striking in of eruptions, self- 
pollution, etc. 

Treatment, — In the first place, remove all causes of excitement. 
Take the patient from school, and require some sort of cheerful out- 
door exercise, daily. Take away all books, and be careful not to do 
anything to occasion anger, or fear, or any kind of injurious excite- 
ment. 

In the second place, regulate the diet, — making it more animal 
and stimulating if it has been too low, and more vegetable and cool- 
ing if it has been too high. 

In the third place, if the above changes have not been sufficient for 
the purpose, open and regulate the bowels with some gentle physic 
(30) (34) for a few days. 

In the last place, build up the nervous system with oxide of zinc 
pills (270), three a day; or iron (73) (80), or black cohosh, scullcap, 
etc. (79), or the compound valerian pill (81). Sulphate of zinc (82) 
will sometimes succeed, when the oxide fails ; and where there is 
scrofula, the iodide of zinc is to be used. 

To these remedies should be added the shower-bath, begining with 
tepid water, and making it a little colder every day. If the shower- 
bath frightens the patient, or is not other^vise well borne, take the 
sponge bath. 

Chronic Chorea. 

This can hardly be said to amount to a disease. It consists rather 
in uncouth tricks, arising from some slight disorder of particular 
muscles, and grown into a fixed habit, such as shaking of the head 
every three to twenty seconds, repeated squinting of the eyes in con- 
nection with a peculiar knitting of the eyebrows, wrinkling of the 
nose, shrugging of the shoulders, lifting the ears up and down, or 
even moving the whole scalp back and forth. These movements are 
commonly made without a consciousness o'f it ; and generally there 



DISEASES OF THE BRAIJf AND NERVES. 171 

is no power to suspend them without a painful effort which cannot 
be easily continued. 

No medical treatment is of any avail. These tricks can only be 
corrected by great watchfulness and effort on the part of the person 
sutfering from them, and in many cases, not even by such means. 

Cramps. 

Cramp is experienced in the calves of the legs, the thighs, the 
stomach, the breast, the womb, etc. It is a very painful, sudden, and 
violent contraction of one or more muscles. The part is sometimes, 
as the phrase is, " drawn up into knots." "When it attacks the stom- 
ach, it is a very dangerous affection. Women are subject to it about 
the third or fourth month of pregnancy. 

Causes. — Drinking cold water when very hot and perspiring, ex- 
posure to damp night air, debility, indigestible food, and excesses in 
eating and drinking, and particularly overstraining the muscles. 

Treatment. — Moderate the excessive labor and straining of the 
muscles which produce the cramps. When*an attack occurs in the 
legs, tie a cord or handkerchief tight around the leg above the affected 
muscle. This will generally produce instant relief. Also rub the 
part with spirits of camphor, or paregoric, or laudanum. 

When it occurs in the stomach, apply warm fomentations, or what 
is better, a mustard paste (165). Then make one grain of morphine 
into four pills, and give one. If this does not bring relief, repeat it 
in half an hour. The bowels, if confined, should be opened with an 
injection. 

Cramps of the limbs which afflict w^omen in the family way, can 
only be mitigated, not cured, till after confinement. As a palliative, 
high cranberry bark, scullcap, etc. (87), will be found useful. 

Pain of the Nerves. — Neuralgia. 

This disease affects one tissue only, — the nervous; and has one 
symptom, — pain. 

In apoplexy^ the nerves, rendered powerless and senseless by an 
external force, are like a man under a bank of earth which has slid 
down upon him. In palsy ^ they are suddenly bereft of feeling and 
motion by a blasting scourge within, — as one is smitten down by a 
pervasive charge from a magnetic battery. In epilepsy^ the nerves 
are grasped and for a time held senseless by an unseen power, in 
which they struggle, as a man strives in the folds of the anaconda. 
In catalepsy^ they are suddenly stiffened into senseless strings, for 
such automatic use as the bystander may, for the time, choose to 
make of them. In chorea^ they are set to dancing by an invisible 
exhilaration, as a man is crazed by brandy. 

In neuralgia^ the nerves are neither crushed, nor collapsed, nor 
restrained for a time, nor stiffened, nor exhilarated. They simply 
have their sense of feeling intensely exalted ; they are fiUed with pain. 



172 



DISEASES OF THE BRAIN AND XERVES. 



The pain is generally of a peculiarly darting, piercing character. The 
patient sometimes calls it tearing pain. It comes on in sudden par- 
oxysms, with intervals of freedom between. The attacks are some- 
times like an electric shock, and are so agonizing as to bring a tem- 
porary loss of reason. Occasionally there is great tenderness of the 
parts affected, and some fulness of the blood-vessels in the neighbor- 
hood ; but generally the signs of inflammation are all absent, except 
pain. 

Neuralgic pains occur in almost every part of the system. One of 
the most familiar forms of the disease is known under the name of 



Tic Douloureux. 

It occurs in those branches of the fifth pair of nerves, which go to 
the face. (See Fig. 82.) Sometimes one, sometimes all of the three 
branches are affected, but more often, 
the middle branch only. When the up- 
per branch is the seat of the disease, 
the pain is in the for^ead, the brow, 
the lid, and sometimes the ball of the 
eye. The eye is generally closed dur- 
ing the pain, and the skin of the fore- 
head is wrinkled. When the affection 
is in the middle nerve, the pain is pre- 
ceded by a pricking sensation in the 
cheek, and twitching of the lower eye- 
lid. Soon it spreads in quick and pierc- 
ing pangs over the cheek, reaching the 
lower eye-lid, the sides of the nostrils, 
and the upper-lip. If in the lower 
branch, it sends its lightning shafts to 
the chin, the gums, the tongue, and 
even up the cheek to the ear. 

Face-Ache. — There is a species of nervous pain called face-ache^ 
which does not quite amount to tic douloureux, but is nevertheless 
very afflictive. It occurs principally in the jaw, which seems to be 
filled with pain. No one spot seems to be more affected than an- 
other. From the jaw the pain often goes to the whole head, but it 
has not the stabbing intensity which generally characterizes neuralgia. 
It often proceeds from defective teeth. 




Hemicrania. 

This is a neuralgic pain, confined to one side of the head, — gen- 
erally the brow and forehead. Sickness of the stomach often attends 
it, and in many cases, it is periodical, — coming on at a certain hour 
every day, and lasting a given time, and then passing away. 

It may be caused by whatever debilitates the system, as hysterics, 
suckling an infant too long, or low diet. Li fever and ague districts, 



DISEASES OF THE BRAIN AND NERVES. 173 

I it is frequently produced by miasm. In many instances, the cause 
cannot be discov^ered. 

Sciatica. 

This is a pain beginning at the hip, and following the course of 
the sciatic nerve. Occasionally it is an inflammatory complaint ; 
sometimes is connected with an affection of the kidney ; but fre- 
quently it is a purely neuralgic or nervous pain ; and I have therefore 
thought it best to place it here, with nervous diseases. 

Beside the various forms of neuralgia now noticed, the disease 
occurs, — sometimes with great severity, — in^the female breast, in 
the womb, in the stomach, in the bowels, in the thighs, in the knee, 
and even in the feet. In many of these cases, the disease is not where 
the pain is felt, but in the brain or spinal marrow, and consequently 
the true. source of the complaint very often escapes detection. An 
excellent Episcopal clergyman in northern New York, the Rev. M. 

B , with whom I studied Latin and Greek preparatory to college, 

had a neuralgic pain in the knee so intense, persistent and exhaustive, 
that the limb had to be cut off' at the thigh to save his life. 

Treatment. — This must be as diversified as the causes of the dis- 
ease. 

For tic douloureux, and some other forms, give, internally, valeri- 
anate of ammonia (88) ; also 89, 90, 91, 92, 93, 316. 

For external use in tic douloureux, and other neuralgic affections, 
the prescriptions 188, 196, 197, 198. 

For the face-ache, above mentioned, muriate of ammonia (134), in 
half dram doses, is a very valuable remedy. 

When the disease is caused by miasm, and has a periodic character, 
like ague, it must be treated with quinine (67) (79), and if there be a 
low state of the blood, iron (72) (93) must be given at the same 
time. 

The shower bath, exercise in the open air, and whatever else will 
build up the general health, must be used according to circumstances. 

Derangement of Mind.— Insanity. 

Most writers on this disease have attempted a definition of it. I 
have never seen one which suited me. Here is mine. Insanity is a 
icrench of man^s nature^ which sets his intellectual and moral facidties 
aivry in their relations with the external world. 

In a state of mental and moral health, he looks straight at the out- 
ward world, and sees it as it is ; insanity gives him an angular con- 
nection with it, and he sees it as it is not; its objects have all changed 
their relative places ; objects at the right in the panorama of life have 
moved to the centre, or gone quite over to the left ; while things at 
the top have gone to the bottom, and those in the lowest places have 
taken the highest. With the thoroughly insane, the vjorld has g-one 
back to chaos. 



174 DISEASES OF THE BRAIX AND NERVES. 

These persons have their sensibility very much altered and per- 
verted. Errors of the senses and illusions cheat them. In many 
cases, they cannot read because the letters are mingled in a confused 
mass. They often do not recognize their freinds, and regard them as 
strangers or enemies. 

They become awkward in the mechanical use of their hands, and 
their, touch loses the powder to correct the errors of the other senses. 
Hence they are cheated in regard to the size, form, and thickness of 
bodies. 

They are haunted, at times, with smells w^hich have no existence, 
and they hear voices distinctly speaking to them from clouds, or from 
trees ; and these voice§ have the familiar tones of a friend, relative, or 
enemy. 

The insane lose the power of comparing ideas. They associate 
things the most unlike, and often in a ridiculous w^ay. 

They also lose the control of themselves, and come under the 
dominion of their passions ; and then they will do acts which they 
themselves disapprove. One of strict integrity, of unblemished mor- 
als, and of excellent standing, becomes insane, and immediately steals 
what he does not w^ant, makes infamous proposals, and indecent ges- 
tures, and is in every respect the opposite of his past self. 

The insane often become averse to those who were previously 
among the most dear to them. For acts of kindness, they repay 
abuse. They fly from their best friends. This is the result of their 
fear and jealousy ; for they are very cowardly and jealous. This alien- 
ation from friends is ahnost a characteristic of insanity, and is one of 
its saddest features. The moral affections are always disordered, 
perverted, or annihilated in insanity. So much is this a leading fea- 
ture of the disease, that it is only w^hen the insane begin to recover 
their moral affections, when they begin to wish to see their children 
and friends, to fold them once more in their arms, and to enter the 
family circle and renew its joys, that we can count upon any certain 
signs of a cure. 

The insane have a thousand strong fancies in regard to themselves. 
One thinks himself inspired of God, and charged w^th the conversion 
of the world; while another, equally sincere, believes the devil has 
entered into him, and that the pains of hell are already taking hold 
of him, and he curses God, himself, and the universe. Still another 
is the " monarch of all he surveys," and much more ; he governs the 
w^orld, and directs the stars. One has all knowledge, and affects to 
teach the wisest. Another is proud, and withdraws from his fellows, 
bidding them not to come into his presence w^ithout proper acts of 
homage, — calling himself, it may be, a king. 

There are five kinds of insanity. I wiil speak of each of them 
briefly. 

Melancholy. — Lypemania, 

This is characterized by moroseness, fear, and prolonged sadness. 
The melancholic person is lean and slender, wdth black hair, and a 



DISEASES OF THE BEAIX AND NEKVES. 175 

pale and sallow countenance. His skin is brown or blackish, and 
dry and scaly. His physiognomy has a fixed appearance, the muscles 
of the face are drawn tight, the eyes are motionless, and directed to 
one point, the look is askance and suspicious, and the general expres- 
sion is one of sadness, fear, and terror. He desires to pass his days 
in solitude and idleness. He walks as if aiming to shun some dan- 
ger. His eye and ear are on the watch for evil. 

These persons do not sleep much. They are kept awake by fear, 
jealousy, and hallucinations. If their eyes close, they see phantoms 
which terrify them. 

Their secretions are disordered. The urine is either abundant and 
clear, or scanty and muddy. They sometimes retain their urine for 
days. One patient did not dare to make water lest he should drown 
the world, but was finally persuaded to it by the assurance that he 
would extinguish a fire which was devouring a city. 

Insanity on One Subject. — Monomania, 

This is a chronic affection of the brain, not attended by fever, and 
characterized by a derangement of the intellect, the affections, or the 
will, upon one subject only. The patient seizes upon a false princi- 
ple, and draws from it injurious conclusions, which modify and 
change his whole life and character. In other cases the intellect is 
sound, but the affections and disposition being perverted, their acts 
are strange and inconsistent. These they attempt to justify by plau- 
sible reasoning. 

Mania. 

This is also a chronic affection of the brain, generally without 
fever. The countenance of the maniac is sometimes flushed, at other 
times pale. The hair is crisped ; the eyes injected, shining and hag- 
gard. Maniacs dislike the light, and certain colors horrify them. 
Their ears are sometimes very red, and are disturbed by a tingling, 
and a rumbling sound. Noise excites and disturbs them. They suf- 
fer from false sensations, illusions and hallucinations ; and their ideas 
come with great rapidity, and are confused and without order. Their 
affections are in a state of turmoil, and their judgments are all erro- 
neous. 

Unlike the monomaniac, their delirium extends to all subjects. 
Their entire intellect, affections and will, are a chaotic wreck. 

Dementia. 

Here is another chronic affection of the brain, without fever, in 
which the sensibility, the intellect, and the will, are all weakened. 
Demented persons have not the power to concentrate their minds on 
anything, and can form no correct notions of objects. Their ideas 
float after each other without connection or meaning. They speak 
without any consciousness of what they are saying. 



176 DISEASES OF THE BRAIN AND NERVES. 

Many of them have lost their memory, or, like old persons, they 
remember nothing recent, — forgetting in a moment what is just said 
or done. 

The demented have neither desires nor aversions ; neither hatred 
nor love. To those once most dear to them, they are totally indiffer- 
ent. They meet friends long absent without emotion, and part from 
their dearest ones without a pang. The events of life passing around 
them, awaken in them no interest, because they can connect them- 
selves neither with the past nor the future ; they have no remem- 
brances, nor hopes. Their brain is inactive ; it furnishes no ideas, or 
sensations. They are no longer active, but passive beings ; they 
determine nothing, but yield themselves to the will of others. 

They liave a pale face, a dull eye, moistened with tears, an uncer- 
tain look, and a physiognomy without expression. They sleep pro- 
foundly, and for a long time, and have a voracious appetite. 

, Idiocy. 

Idiocy is the condition in which the intellectual faculties have 
never been manifested. We are not to infer disease from it, any more 
than we infer it in the lower animals from the absence of intellect. 

In idiocy there is no mind, because the brain is not large enough 
to be the organ of intelligence. It always dates back, therefore, to 
the beginning of life. Everything about the idiot betrays a defective 
organization. The demented person, the monomaniac, etc., once had 
intelligence ; the idiot, never. They, in many cases, may be cured ; 
he is hopelessly incurable. They had blessings which have been 
taken from them ; to him, none were ever given. They were once 
the pride and hope of their friends ; he, from his birth, was the smit- 
ten and blasted one of his family. He never reaches an advanced 
age, — rarely living beyond thirty years. 

These remarks are sufficient to show the difference between idiocy, 
and other forms of mental derangement. In the other forms of in- 
sanity there are brains enough, but they are diseased ; in this there is 
no disease ; the smallness of the brain is the primal and fatal defect. 

This form of mental derangement is caused by a defective develop- 
ment of the brain. That the other forms are produced by disease of 
the brain, there can be no doubt. 

Some have supposed insanity to be a mental disorder merely, hav- 
ing nothing to do with the body. They might as well suppose the 
delirium of fever to be a disease of the mind only. 

Insanity is an unsoundness of the brain and nerves which proceed 
from it, in every instance. At first it is probably only excitement of 
the brain ; but this, long continued, becomes a chronic inflammation. 
The brain and nerves of an insane person are undoubtedly sore, and 
hence the painful thoughts and feelings which afflict them. When 
the soreness is much increased, they are violent and furious ; when 
it subsides, they are calm. In consequence of this inflammation 
and soreness of the brain, an insane person can no more think, or 
reason, or will, or feel correctly, than a person with an inflamed 



DISEASES OF THE BRAIN AND NERVES. 177 

stomach can digest food well, or than one with inflamed eyes can 
see well. 

Causes of Iiisiinitj'. — Hereditary predisposition ; painful subjects 
of thought or feeling long revolved in the mind ; injured feelings 
which cannot be resented, mortified pride, perplexity in business ; 
disappointed affection or ambition ; great political, religious, or social 
excitements ; sudden and heavy strokes of misfortune in the loss of 
property and friends; and in general, whatever worries the mind for 
a long time, and creates a deep distress, may be a cause of insanity. 

But one of the most prolific causes, and worthy of special mention, 
is masturbation, or self-pollution, — a vice contracted by thousands 
of young people, both male and female. 

Beside the above, I may mention several physical causes, as con- 
vulsions of the mother during gestation, epilepsy, monthly disorders 
of women, blows upon the head, fevers, loss of sleep, syphilis, exces- 
sive use of mercury, worms in the bowels, and apoplexy. 

Chances of Cure. — Idiotism is never cured. 

Melancholy and monomania are cured when recent, and do not 
depend upon organic disease. 

Dementia is sometimes, though seldom, cured. 

Chronic insanity, of long standing, is not easily cured. 

Insanity which has been produced by moral causes, acting sud- 
denly, are generally curable ; if the causes have acted slowly and 
long, the cure is more doubtful. 

Excessive study causes insanity which is hard to cure. 

If caused or continued by religious ideas, or by pride, it is not often 
cured. 

Insanity caused and maintained by masturbation, is cured with 
great difiiculty. 

Treatment, — The treatment of the insane is now almost confined, 
as it should be, to public hospitals. In these institutions, all the 
means are provided which humanity has been able to devise, to lift 
from these unfortunate beings the terrible shadow which is upon 
them. Here they have safety, comfort, recreation, friendly guardians, 
rest, and medicine. 

They have safety from the annoyances which well-meaning but 
mistaken friends at home almost always commit in contradicting, and 
reasoning with, persuading, and threatening them ; for only in these 
humane institutions has it been well learned that to do so is no wiser 
than to persuade, scold, or threaten a neuralgic pain in the face, an 
inflammation in the stomach, or a felon upon the finger. They are 
safe, too, from the impertinent scrutiny of neighbors, the hootings of 
unthinking boys in the streets, and especially from the causes, what- 
ever they are, which have produced the disease. And so far, this is 
just the treatment they want, — no contradiction, no impertinent 
scrutiny from neighbors, no abuse in the streets, and a withdrawal of 
the causes which have produced the disease. 

In these institutions, too, they have comforts. They have clean 

23 



178 DISEASES OF THE BRAIN AND NERVES. 

rooms, galleries, lodges, bathing-rooms, yards and gardens for exercise 
and walking, safe, quiet, well-aired bed-rooms, and clean and com- 
fortable beds ; cheerful dining rooms, and plain, wholesome, and 
nutritious food. And this, likewise, is the treatment they require. 

They have recreation, — dances, cards, back-gammon, chequers, 
chess, billiards, nine-pins, walking parties, riding parties, gardening, 
and an indulgence in those arts of painting, music, drawing, and 
architecture, for which they may have a taste. And such recreations 
are powerful instruments in the cure of all disorders of the nervous 
system. 

Here, too, they have friendly guardians, who have long studied 
their complaints, and have imbued their souls with a sympathy which 
goes down into the depths of their sufferings, and allies itself with 
all their sorrows ; — men and women who are willing to act the part 
of guardian angels ; to be their friends ; who know how to gain their 
confidence ; and who use the influence acquired by love, in leading 
them back towards health and happiness. And this, too, in curing 
the insane, is of great consequence, for none can do them good till 
they have their confidence, and this can be gained only by love and 
wisdom. 

In these insane asylums, they find rest. When the brain is hot 
from inflammation, and they are raving from delirium, they are here 
withdrawn from the noisy crowd, and shielded from the rude shocks 
of the world. If need be, they are placed in solitary rooms, where 
silence spreads its soothing stillness through their excited brains. And 
it is of the greatest importance that the sore and torn feelings should 
rest ; for rest allays excitement, and brings sleep ; and without a proper 
amount of sleep, recovery is not possible. 

Finally, in these institutions, they receive the best medical treat- 
ment. They have warm and cold bathing, judiciously administered ; 
they have simple cathartics when the bowels are bound, as salts, cas- 
tor oil, and magnesia ; tonics for debility, such as quinine, iron, quas- 
sia, columbo, and chamomile ; and quieting medicines for their ex- 
citement, such as opium, morphine, cicuta, hyoscyamus, belladonna, 
stramonum, scullcap, and valerian. Prescription 74 is a combination 
much used. Here, too, broth, gruel, and milk, are administered by 
the forcing pump to such as take a fancy not to eat, — an expedient 
which has saved many lives. Fruits of all kinds, as strawberries, 
cherries, currants, plums, apples, peaches, and grapes, are allowed 
freely. Cold water, sweetened or otherwise, is the drink. To these 
things are added lively conversation, and whatever will divert the 
mind from reflection, and internal imaginings and revery. 

Thus I have indicated, very briefly, the treatment which the insane 
receive in public institutions. That the chances of recovery in these 
humane retreats is much greater than at home, does not admit of a 
doubt. When it is not convenient to send an insane person to a 
hospital, the treatment should be as near like the one here sketched 
as circumstances will permit. 



DISEASES OF THE BRAIN AND NERVES. 179 



Hypochondria. 

The common names of this disease are low spirits, spleen, vapors, 
hypo, and the blues. It produces constant fear, anxiety, and gloom. 
Business, pleasures, the acquisition of knowledge, and all the useful 
pursuits of life, become insipid, tasteless, and even irksome to the 
hypochondriac. His mind is full of the belief that something dread- 
ful is about to befall him. He is either going to be sick, or to die, or 
lose his property or friends. He has no mind to engage in any busi- 
ness, nor does he wish to go anywhere, or to see anybody. Night 
and day his spirits are down to zero, and his heart has a load too 
heavy to bear. He is wholly occupied with his troubles, and his feel- 
ings. He thinks he has various diseases, and wears out his friends 
by talking of his sufferings. He feels of his pulse often, looks at his 
tongue - in the glass, and several times a day asks a friend if he does 
not look pale or sick. 

The external senses manifest symptoms of derangement as well as 
the thoughts, feelings, emotions, and passions. There are roarings in 
the ears, like a waterfall, or the noise of a distant carriage. Floating 
black specks, or bright sparks, are seen before the eyes. These indi- 
cate a slight fulness of the blood vessels, and perhaps, in some in- 
stances, sparks of electricity passing to or from the eye, and are in no 
proper sense subjects for the alarm they cause. At one time the 
person will feel as large as a barrel, at other times not larger than a 
whip-stock ; the head will feel light or heavy, large or small. The 
skin will twitch in different parts, or feel numb, or have the sensation 
of spiders crawling on it. The smell and taste become perverted ; 
the hypochondriac will smell odors and flavors, at times, where there 
are none. - 

These errors of the senses are all owing to some slight disorder of 
the organs of sense ; and they are no more wonderful than that the 
mind should perceive personal danger, poverty, and death itself, when 
none of these things are impending. 

These persons are subject to fainting turns, when the breathing will 
appear to stop, the body become cold, the face pale ; there will be 
distress in the region of the heart, which will apparently stop beating, 
and the person will feel as if dying. At the same time the mind will 
remain clear. These nervous spells are alarming, but pass off with- 
out danger. 



These persons become changed in their moral dispositions. They 
are jealous, take a joke as an affront, and feel the greatest distress at 
any apparent lack of attention or neglect on the part of friends. 
They put the worst construction upon the actions of friends. They 
are irritable, fretful, peevish, and fickle. 

The complaint is distressing, but does not appear to shorten human 
life. 

The seat of the disease is in the brain and nerves. It is caused by 
anxiety, care, disappointment, working the brain too hard, diseases of 



ISO DISEASES OF THE BRAIN AND NERVES. 

the liver and stomach, costiveness, sedentary habits, excessive venereal 
indulgence, and masturbation. 

Treatment, — This disease is more easily prevented than cured. It 
would be almost entirely prevented in this country if in childhood we 
were all taught to be contented with humble competence, to love 
active labor, and to think it honorable, instead of struggling after 
wealth, and falling into unhappiness when it does not come. 

Remedies, — Of all the remedies for this complaint, that which is 
most important is active employment out of doors. The human 
body was made for motion. Without it the blood cannot be dis- 
tributed to the several organs. The senses, — the eye, the ear, the 
touch, — should be much in communion with nature. In this way 
they are strengthened. Nature is their great physician. Man is a 
creature of sensation ; and if too much occupied with feelings, 
thoughts, and deep reflections, the nerves will be irritated, and begin 
to give deceptive sensations. A very nervous man should fly to some 
active occupation, if he would be rid of suffering. 

The open, fresh air is very important to restore the system to 
soundness. 

Temperance, both in eating and drinking, will do much for this 
class of patients, yet they are the very persons who eat largely, and 
they often fly to the excessive use of stimulants to drive away their 
sorrow. By so doing, they aggravate the disease. 

Amusements are very important for hypochondriacs. Lively com- 
pany, cheerful and witty conversation, with mirth and laughter, lively 
songs and instrumental music, are all desirable ; and so are gunning, 
fishing, riding, billiard-playing, and travelling. 

Never allow these patients to be alone, and to have time to brood 
over their misery. See that they go early to bed, and rise betimes in 
the morning. The warm bath, the cold shower, or sponge bath, with 
brisk friction, are not on any account to be omitted. The diet should 
be light, nutritious, and generous ; but fats, acids, liquors, and coffee, 
must be forbidden. 

But little medicine will be required. If there be costiveness, let the 
cracked wheat be eaten ; if this do not answer, a little rhubarb and 
bicarbonate of potassa (35), or leptandrin, podophyllin, etc. (36), may 
be given as required by the symptoms. A teaspoonful of calcined 
magnesia once a day, or the infusion of thoroughwort, drank cold, 
will often answer an excellent purpose. A bowl of warm mother- 
wort tea, with a teaspoonful of spirits of camphor in it, will do well 
in fits of fainting when there is a sensation of dying. A teaspoonful 
of sulphuric ether may be given at the same time. If there be debil- 
ity, tonics are sometimes useful (50) (49) (54) (55). 

Hiccough. — Singultus, 

This is a sudden, jerking spasm of the midriff, occurring every few 
moments in bad cases, causing the air to be driven out of the lungs 



DISEASES OF THE BRAIN AND NERVES. 181 

with such suddenness as to produce a noisa something like the invol- 
untary yelp of a puppy. It is generally caused by acidity of the 
stomach, which irritates the nerves distributed to its neighborhood, 
and is not difficult to remove ; but when it occurs towards the close 
of some acute and grave disease, it is sometimes a sign that dissolu- 
tion is at hand. 

Treatment. — Startle the person suffering, by exciting surprise, or 
fear, or anger ; or, let a few small draughts of cold water be taken in 
quick succession ; or, let the breath be held as long as possible. If 
the stomach is sour, take a teaspoonful of bicarbonate of soda, dis- 
solved in half a tumblerful of cold water. To expel wind from the 
stomach, if it be present, take some warm aromatic-essence of pep- 
permint, etl>er, or compound spirits of lavender. But one of the 
most effectual remedies, is heavy pressure made upon the collar bones. 
It is simple, and very effectual. 

Tainting. — Syncope, 

Fainting is preceded by a distress about the heart, a swimming of 
the head, sometimes sickness at the stomach, coldness of the hands 
and feet, and a loss of sight, or a sense of things groioing dark. The 
breathing diminishes, the pulse becomes small, the face deadly pale, 
and the patient wilts down, and becomes more or less unconscious of 
what is passing around. 

Whatever causes debility, particularly of the nervous system, will 
predispose to fainting. Persons much weakened by disease, faint 
easily, — especially when they attempt to stand stilL When on their 
feet, such persons should keep moving. Fainting is sometimes in- 
duced by sudden surprizes and emotions, by violent pains, by the 
sight of human blood, and by irritation of the coats of the stomach 
by indigestible food. 

Treatment. — Lay the patient upon the back, with the head low ; 
let fresh air into the room instantly, and apply gentle friction. 
Sprinkle a little cold water upon the face, and hold spirits of cam- 
phor, ether, hartshorn, or vinegar to the nose, — rubbing a little of 
the spirits of camphor upon the forehead, and about the nostrils. As 
soon as the patient can swallow, give a teaspoonful of compound 
spirits of lavender, with ten drops of water of ammonia in it. 

Persons subject to fainting should not go into crowded assemblies 
where the air is bad ; neither should they wear tight dresses, or allow 
themselves to get excited. Cold bathing, a well-regulated diet, and 
vegetable tonics, will do much to break up the habit. 

Dizziness of the 'Ee^,^,— Vertigo. 

This affection makes objects which are stationary appear as if 
moving, or, as the phrase is, " turning round." When seized with it, 
one will have a sensation as if falling, and objects about him will 
seem to be in motion. • 



182 DISEASES OF THE BRAIN AND NERVES. 

It is caused by irritation of the nerves of the stomach in dyspepsia, 
by long application of the mind, by a weakened nervous system, by 
hysterics, and by a fulness of the blood-vessels of the head. When it 
proceeds from most of these causes, it is not dangerous ; but when 
caused by impending apoplexy, it is a symptom of very serious im- 
port. 

Treatment. — Find out the cause and remove that, and the dizzi- 
ness will disappear. If it come from dyspepsia, eat lightly; if from 
costiveness, open the bowels either by coarse food, by daily cold 
water injections, or by some gentle physic. Avoid coffee, ardent 
spirits, and late suppers, and take much exercise. Keep the feet 
warm, and the head cool. 

Disturbed Sleep.— Nightmare. — Incubus. 

In this complaint the sleep is disturbed generally by some frightful 
image. Whatever of an alarming character is presented to the mind 
in sleep, causes fear, or some other painful emotion, the same as when 
awake. And when the attempt is made to resist, or to flee from the 
danger, it is ineffectual, because the muscles are locked fast in sleep. 
The fear being increased by the inability to escape, the sleeper makes 
all sorts of horrible noises, indicating distress of mind. The danger 
seen is as real to the sleeper as if he were awake, and he tries to do 
just what he would if awake. Sometimes the sensation is that some 
heavy weight, or perhaps some horrible monster, is upon the breast, 
nearly pressing the breath out of the body. 

At times, the power of motion is not absent, and then disturbed 
dreams may cause one to talk, or to rise and walk, or run. 'Children 
will laugh, or cry, or scream, which shows that their minds are agi- 
tated by different passions. Persons who idulge gloomy and troub- 
lous thoughts in their waking hours, are apt to be disturbed with 
sleep-walking, sleep-talking, and frightful dreams, as of falling down 
precipices, during the hours for repose. 

There is nothing very wonderful about these disturbances of sleep. 
It is only necessary that there should be an unusual sensitiveness 
of the brain, or that a hearty supper, eaten late, should irritate the 
nerves of the stomach, and that distressing thoughts should be dwelt 
upon during the day and evening, in order to produce all the walk- 
ing, talking, dreaming of hobgoblins, shipv\rrecks, fires, and polar bears, 
which distress so many unfortunate sleepers. 

In night-walking there is simply a little more wakefulness than in 
night-talking, and in this latter, more than when one falls from a high 
place, and in this perhaps slightly more than in real incubus^ when 
one is in the greatest peril, but cannot move at all. 

Treatment. — When sleeping persons groan, or make any noise 
indicating nightmare, shake them, and they will come out of it at 
once. As these troubles are often caused by a weakened state of 
the nerves, much out-door exercise should be taken. The diet should 
be simple, and well regulated. The suppers should be light, and 



DISEASES OF THE BRAIN AND NERVES. 183 

never taken late. The evening should be spent in some pleasant 
amusement, which will drive away care ; and the last hours of wake- 
fulness be occupied with pleasant reflections. One afflicted with 
nightmare should not lie upon the back, nor with the hands over the 
head, xlcidity of the stomach, and costiveness, if they exist, should 
be removed by the neutralizing mixture. 

Headaches. 

These are not always caused by disorders of the brain and nerves, 
but they frequently are, and this seems the proper place to speak of 
them. 

It is unwise ever to neglect headaches. They are sources of great 
suffering, and often lead to serious derangements of the health In 
childhood they have a more serious meaning than in adult life. They 
often indicate the approach of scarlet fever, or measles, or of other 
diseases. 

Headaches are more common among the civilized than the uncivil- 
ized ; more frequent among females than among males ; among those 
of sensitive feeling than among the more obtuse ; among those who 
think much than among those who think little ; among the sedentary 
than among the active. 

Causes of Headaches. — They are dependent on various causes, as 
derangement of the circulating system, of the digestive organs, of the 
nervous system, etc. Among those dependent on disturbance of the 
circulation, are 

Plethoric Headaches. — These are dependent on a general fulness 
of blood They are of two kinds. One is occasional, and lasts but 
a few hours. The other lasts for days or weeks. It occurs most 
often in the night or morning, Persons whose occupations require 
stooping have it most. A little dizziness is generally felt on rising 
up from a stooping posture. It is brought on by the bad air of 
crowded rooms, and is attended by costive bowels, short breath, and 
a white furred tongue. 

The persistent headache is accompanied by a sense of fulness, and 
sometimes of throbbing over the brows and temples, with a sensation 
of dizziness, and of mist before the eyes. The sufferer fears exertion, 
and is constantly looking for a rush of blood to the head. Nature 
sometimes relieves this form of headache by a diarrhoea, or by bleed- 
ing from the nose. 

There is another form of plethoric headache, differing slightly from 
the above, in which there is too much blood, and it is made too fast^ 
but it does not circulate so rapidly. The muscles are not very firm, 
and the heart does not propel the blood with much force. This form 
of headache is connected with congestion. 

Headaches of Indig'estion. — These are caused either by taking im- 
proper articles of food, or by eating too much of those which are 
proper. The sensation in the head is not always a pain, but aome- 



184 DISEASES OF THE BRAIN AND NERVES. 

times only a dull weight, attended by languor and disinclination for 
exertion ; a tongue white in the centre, and pale red at the tip and 
edges ; cold and numb fingers ; slight nausea ; languid and feeble 
pulse ; dim and indistinct sight ; eyes aching when employed ; and 
difficulty in fixing the attention. 

Sick Headache. — This has received its name from the constant 
nausea or sickness at the stomach which attends the pain in the 
head. 

This headache is apt to begin in the morning, on waking from a 
deep sleep, or after sleeping in a close room, and when some irregu- 
larity of diet has been committed on the day before, or for several 
previous days. At first there is a distressingly oppressive feeling in 
the head, which gradually merges into a severe, heavy pain in the 
temples, frequently attended by a sense of fulness and tenderness in 
one eye, and extending across the forehead. There is a clammy, un- 
pleasant taste in the mouth, an offensive breath, and the tongue 
covered with a yellowish-white fur. The sufferer desires to be alone, 
and in the dark. The hands and feet are cold and moist, and the 
pulse feeble. 

Accompanying these symptoms, there is a depressing sickness at 
the stomach, which is increased by sitting up, or moving about. After 
a time, vomiting comes, and relief is obtained. 

Bilious Headache. — This is most common in summer and autumn. 
It afflicts persons of dark complexion, with black hair and melancholy 
dispositions. There are two kinds ; one is due to an accumulation of 
bile in the system ; the other to a large secretion of bile. 

In the first variety the skin is dingy and sallow, the spirits de- 
pressed, the bowels costive, and there is wind in the stomach, with a 
dull, aching pain on the right shoulder. The pain is in the forehead, 
eyebrows, and eyelids, and the " white of the eye " is a little yellow- 
ish. The tongue has a brown fur, and is cracked in the centre. 
There is a bitter taste in the mouth on waking in the morning, after 
restless nights, and frightful dreams. 

In the second variety, which is due to an " overflow of bile," the 
symptoms are much like those of the first kind, but the pain is not so 
continuous. In addition to the symptoms named, there is a throb- 
bing, rending pain in the head, the skin is hot and the face flushed, 
the limbs are sore, and there is a luminous halo or ring around objects 
looked at, and a feeling of giddiness. 

XervoiiS Headaches. — These are more common among females 
than males. They occur most frequently among persons of high 
susceptibility, who are easily elevated, and as easily depressed. They 
are often connected with indigestion. 

The pain is usually acute and darting, and is made worse by light, 
with a feeling as if the temples were being "pressed together," and a 
" swimminess " in the head. There is sometimes a sense of sinking, 
with a dread of falling, and great despondency and restlessness. The 
bowels are generally costive, and the sight dim. The pain comes 



DISEASES OF THE BRAIN AND NERVES. 185 

on most commonly in the morning, lasts through the day, and abates 
in the evening. 

Hysteric Headache. — There is a nervous headache dependent on 
the hysterical condition. It is generally confined to one small spot, 
frequently over the eyebrow, and is sometimes compared to a wedge 
or nail driven into the skull. 

Headache from Exhaustion. — Still another species of nervous head- 
ache arises from extreme exhaustion, produced by great loss of blood, 
by diarrhoea, or by over-suckling. The pain is generally on the top 
of the skull, and is often compared to the beating of a small hammer 
on the head. 

Brow Ao'ue. — This is intermittent in its character, and is brought 
on by exposure to cold and moisture in damp and marshy districts ; 
and in this respect is much like ague. 

Heo:rims. — This is most frequent among females. It is often de- 
pendent on the same causes as Brow Ague, and is also produced by 
long and exhausting watching over sick children, distress of mind, 
and indigestion. 

In both the above forms, the pain is intermittent, seldom lasting 
long, but being of a sharp, piercing character, like that of tic doulou- 
reux. The pain of Megrims, usually begins at the inner angle of the 
eye, and extends towards the nose ; the parts being red and sore, and 
the eye-ball tender. In Brow Ague, pain and great tenderness cover 
an entire half of the head, compared by the patient, sometimes, to 
" an opening and shutting of the skull." It begins with a creeping 
sensation over the scalp. 

Rheumatic Headaches. — These generally affect persons who have 
been subject to rheumatism, and are often brought on by uncovering 
the head w4ien sweating. The pain is usually in the brow, the tem- 
ples, or the back of the head, and is dull and aching, — rather an 
intense soreness than a real pain ; and the painful part is exces- 
sively tender upon pressure. The skin is moist, but not hotter than 
natural. 

Treatment. — In considering the treatment, I will take up. the same 
order in which I have spoken of the different forms of headache. 

Plethoric Headaches. — Not much medicine should be taken for 
these, if it can be avoided. A diuretic (317) may be taken twice a 
day, and an occasional dose of gentle physic at night, followed by (7) 
in the morning. This will generally give great relief. 

Meat should be taken but once a day, and the whole diet should 
be spare, the appetite never being fully satisfied. All spirituous 
drinks, including distilled and fermented, should be let alone, and 
coffee likewise. 

Much exercise should be taken in the open air. The hair should 
be kept short, and the head elevated during sleep. Bleeding at the 
nose, when it occurs, must not be too suddenly stopped. 

24 



186 DISEASES OF THE BKAIX AND NERVES. 

Cong'estive Headaches. — The exercise, diet, mode of sleeping, etc., 
should be the same as in plethoric headaches. In this complaint, there 
is too much blood in the head, and it inclines to stagnate. The feet 
and hands are cold ; and gloves and stockings of wool, and other bad 
conductors of heat from the body, must be worn. 

Occasionally a little gentle physic (319) is desirable to induce the 
bowels to act every day. If there is great debility, iron (71) (74) (74) 
(320) will be required. 

Headache of Indig'estion. — If the pain come immediately after a 
meal, and can be traced to something eaten, an emetic (2) may be 
taken, if the person be tolerably strong. If the pain come on some 
hours after eating, take rhubarb and magnesia (28) (14), or fluid 
magnesia. "When the system is debilitated, take a warm draught 
(322) in the morning after a light breakfast, or twice a day, a bitter 
with an alkali (323). If the stomach be very irritable, bismuth, at 
meal times (324) (324). When it occurs after a debauch, take recipe 
325. 

Sick Headache. — When it results from food taken, a draught of 
warm chamomile tea, or a little weak brandy-and-water, will generally 
give relief. If the sickness continue, soda and water, with a little 
ginger may do w^ell, or a mustard poultice upon the stomach (165) 
may be required. As soon as it can be kept on the stomach, a 
dose of physic (326) must be taken ; and if relief does not come after 
the operation of this, give a bitter and an aromatic (327). The patient 
must have perfect rest. If there be great lack of tone in the system, 
the mineral acids (328) (329) will be excellent. 

The diet must be carefully regulated, as in plethoric and congestive 
headaches. 

Bilious Headaches. — These are generally connected, more or less, 
with some affection of the liver. 

Daring an attack, if the suffering be great, attended by nausea, 
give an emetic (2). In milder cases, give recipe (321). If there be 
costiveness, give recipe (330) at night, and (7) in the morning. 

A few doses of podophyUin, leptandrin, etc. (34) (36) (39), to re- 
lieve the liver when the bile does not flow fast enough, will diminish 
the frequency and force of the attack. The fluid extract of dandelion, 
taken for some time, often does good service. 

The diet should be light, and chiefly vegetable, and exercise in the 
open air must not be omitted. The daily sponge bath, with friction, 
is excellent. 

jVervoiis Headaches. — The first thing to be done is to relieve the 
pain, and this may generally be accomplished either by preparation 
(331), or (332), or (333), or (88), or (93), or two or three drops of 
tincture of nux vomica in a spoonful of water, taken three times a 
day. 

In simple nervous headache, diet is of the greatest importance ; in 
hysterical cases, exercise ; in headaches from exhaustion, tonics (81) 
(79) (63) (73) (64) (61) (60). 



DISEASES OF THE BRAIN AND NERVES. 18T 

Rheiuuatic Headaches. — Take a light diet, with but little animal 
food. Wear warm clothing, and avoid exposm-e to wet feet and 
dampness generally, and go to a mild climate, if convenient. 

When the local pain is great, apply hot fomentations, or a stimu- 
lating liniment (334), or a mustard poultice, to the back of the neck. 
In the beginning of the treatment, a little physic at night (335) is 
useful. 



DISEASES OF THE THROAT. 



The diseases which seat themselves in the throat, and in the great 
cavity of the chest, have occupied a large share of my attention for 
the last ten years. My practice in these complaints has been large, — 
being drawn from every part of the United States, and the British 
Provinces. No class of diseases from which men suffer are more nu- 
merous than these, and none have so generally baffled the skill of the 
profession. For this reason, I wish to present here a brief, practical, 
and common-sense view of these complaints, which shall be of real 
value to the thousands of families, who, I trust, will consult these 
pages. 

Increase of Throat Diseases. — A striking increase in the number 
of throat diseases has been witnessed within the last few years. A 
person suffering from any of them will find, on speaking of his com- 
plaint, that a number of his neighbors are afflicted with troubles of a 
similar kind. I have thought that in some of their forms these dis- 
eases have fastened upon the throats of not less than half our popu- 
lation. And when it is considered that they are the natural, and 
if unmolested, the certain harbingers of lung disease, it is wise to 
make a note of the above fact. As I shall describe them in the nasal 
cavities, the pharynx, the fauces, etc., they all have a natural proclivity 
downwards. From these upper cavities they pass, by one short step, 
into the larynx, — the cavity where the voice is formed, — and then, 
by another equally short and easy stage, into the body of the wind- 
pipe. It is a singular fact that their progi'ess is always from the 
upper breathing passages downward, and never from the lower pas- 
sages upward. They afford a parallel to the order of progression in 
the moral world, in which evil tendencies are toward a lower depth. 

A ^listake Corrected. — Before describing the several diseases which 
belong to this family, I wish to correct the mistake which so generally 
classes them all under the term Bronchitis. 

They all consist in a simple inflammation, acute or chronic, either 
of the mucous membrane lining the several cavities to be spoken of, 
or of the small glands or follicles connected with that membrane; and 
each disease takes its name from its particular location. Thus, the 
inflammation of the membrane lining the upper part of the throat, or 
pharynx, is called Pharyngitis. Inflanmiation in the top of the wind- 



DISEASES OF THE THROAT. 



189 



pipe, or larynx, is Laryngitis. In the windpipe, or trachea, it is Tra- 
chit is. In the bronchial tubes, it is Bronchitis. As the bronchial 
tubes exist nowhere except in the lungs, below the division of the 
windpipe, there can be no Bronchitis in the throat. Nevertheless, it 
is the same disease with Laryngitis and Pharyngitis, and differs from 
them only in being in a more dangerous place. 

As the wdndpipe descends into the chest, it divides below the top 
of the breast bone into two branches, one going into the right, the 
other into the left lung. These branches divide and subdivide very 
minutely, and send their ramifications into every part of the pulmon- 
ary tissue. Thus situated, Meckel has compared the windpipe to a 

Fig. 83. 




hollow tree with the top turned downward, — the larynx and trachea 
representing the trunk, and the bronchial tubes, with their innumera- 
ble subdivisions, the branches and twigs. (Fig. 82.) 

K the reader will now understand that the trunk and branches of 
this bronchial tree are hollow throughout, and lined with a delicate 
and smooth mucous membrane, and that the diseases to be described 
are inflammations either upon this membrane or the small glands 
connected with it, causing swelling, redness, unhealthy discharges, 
roughness, etc., he will have a good general idea of them. 



Nasal Catarrh. 

I TAKE these diseases in the order of their location. Nasal Catarrh 
consists in inflammation, which begins behind and a little above the 
veil of the palate, and extends upward from thence into the nose. It 



190 DISEASES OF THE THROAT. 

is an exceedingly troublesome complaint, and afflicts great numbers. 
It passes under the name of Catarrh in the Head. 

The inflammation is not confined to the nasal cavities. It extends 
frequently to the air cavities, called antrums and sinuses^ which cover 
a considerable portion of the face, and extend to the lower part of the 
forehead. Persons sometimes feel as if their whole face were involved 
in the disease, and were almost in a state of rottenness, — so great is 
the amount of matter discharged from the head. Such free discharges 
cannot be wondered at when we reflect that all the air cavities in the 
face are lined with the same mucous membrane which lines the nose, 
and that they all communicate with the nasal cavities. 

The " horn ail," among cattle, is a similar inflammation of the 
inner surface of horns ; and the " horse distemper " is an inflamma- 
tion of the air cavities in the head of the horse, and is much the 
same disease with our catarrh in the head. 

The catarrh often creates ?i perpetual desire to swalloiv, and gives 
the feeling, as patients express it, " as if something were sticking in the 
upper part of the throat^ 

When the inflammation has existed a long time, and ulceration has 
taken place, puriform matter is secreted, and drops down into the 
throat, much to the discomfort of the patient. Indeed, this is one of 
the most distressing features of the complaint, as this matter often 
descends into the stomach in large quantities, causing frequent vom- 
iting, and a general derangement of the health. Many times the 
sufferer can only breathe with the rnouth open. Upon rising in the 
morning a great effort is required to clear the head and the extreme 
upper part of the throat. There is occasionally a feeling of pressure 
and tightness across the upper part of the nose ; and the base of the 
brain sometimes suffers in such a way as to induce headache, vertigo, 
and confusion. The smell is frequently destroyed, and sometimes 
the taste. The inflammation sometimes gets into the eustachian 
tubes, the mouths of which are behind and a little above the veil of 
the palate, and extends up the lining membrane to the drum of the 
ear, causing pain or deafness, and occasionally both. In addition to 
this catalogue of evils, there is often added inflammation and elon- 
gation of the uvula or soft palate. 

Treatment. — The following is a fair illustration of my mode of 
treatment: 

On the 12th of December, 1852, Mr. , of this city, came under 

treatment for a bad case of catarrh in the head, complicated with 
follicular disease of the pharynx, or upper part of the throat. In 
addition to nearly all the symptoms mentioned above, he had a stench 
from the nose exceedingly offensive to all about him.. So much had 
the disease worn upon him that he had become bilious, sallow, de- 
jected, and low in strength and flesh. When it is said that to all 
this were added a cough and loss of appetite, with insidious ap- 
proaches of hectic, it will not be surprising that his friends saw the 
most serious results impending, even though assured by me that the 
disease had not yet taken firm hold of his lungs. The first thing 



DISEASES OF THE THKOAT. 191 

done for him was to cut olT the uvula. Five days after, I began to 
bathe the whole nasal cavity, three times a week, with a shower 
syringe, by pushing the smooth bulb up behind the veil of the palate, 
and throwing instantaneously a most delicate shower of medicated 
fluid up both sides of the septum. The upper part of the throat was 
likewise bathed by the use of a shower syringe made expressly for 
that part, and the larynx, or place where the voice is formed, by a 
long, bent instrument made to reach this part of the throat. The 
sohttion used consisted of half a dram of crystals of nitrate of silver 
dissolved in one ounce of soft water. 

The nitrate of silver powder was inhaled once a day with the powder 
inhaler. In this way the nasal cavities and throat were kept cleansed, 
and the articles used gradually subdued the inflammation, setting up 
a new and healthful action in place of the diseased one. The stom- 
ach was relieved of the offensive matter which had daily and nightly 
gone down into it, and the system of the poisonous effects of its absorp- 
tion. The great danger which threatened the lungs, and which would 
soon have been realized in their destruction, passed away. The skin 
gradually assumed its proper color; the appetite, flesh, spirits, and 
strength came back, and Mr. B. has been since in the enjoyment 
of good health, pursuing his business cheerfully. 

When the above treatment fails, as it does occasionally, I am in 
the habit of changing the solution, using, sometimes, a weak solution 
of acid nitrate of mercury, twenty drops to an ounce of water. In 
other cases, a solution of sulphate of zinc serves a good purpose. A 
dilution of the tincture of arnica flowers is a preparation of some 
value in these cases. There are other preparations, too numerous to 
mention, which I am in the habit of using. I will add, that the 
nitrate of silver powder, snufTed once a day, a pinch at a time, is far 
more successful than any other snnff ever made. 

Inflammation of the Pharynx. — Pharyngitis, 

This is an inflammation of the upper and back part of the throat, 
or all that part which can be seen when the mouth is stretched open. 
It causes a redness of the mucous membrane lining the part, which 
is deep in proportion to the intensity of the inflammation. This 
complaint is generally connected with the one I am about to describe ; 
and since the treatment is the same, the reader is referred to what 
next follows. 

Clergymen's Sore Throat. — Follicular Pharyngitis. 

This disorder made its appearance in this country in 1830, and the 
attention of the profession was first drawn to it, as a distinct disease^ 
in 1832. Some have supposed its origin to have had a hidden con- 
nection with the epidemic influenza, which spread over the civilized 
world in 1830, and affected all classes of persons ; but this is only 
conjecture. In its early developments it attracted notice chiefly by 
its visitations upon the throats of the clergy. Hence its popular 



192 DISEASES OF THE THROAT. 

name of Clergymen^ s Sore Throat. It was soon found, however, to 
attack all classes of persons indiscriminately, whether engaged in any 
calling which required a public exercise of the voice or otherwise. It 
was noticed more by public speakers and singers, on account of the 
greater inconvenience it gave them. 

The disease consists in a chronic inflammation of the mucous fol- 
licles, or glands connected with the mucous membrane which lines 
the throat and windpipe. The office of these little glands is to secrete 
a fluid to lubricate the air passages. When inflamed, they spread an 
acrid, irritating fluid over surrounding parts, which excites inflamma- 
tion in them. Hence a general inflammation of the upper part of the 
throat, or pharyngitis, usually attends the follicular disease, and I 
shall speak of the two together. This inflammation of the glands 
and the membrane, being neglected, as it generally is, lingers on from 
month to month, or from year to year, making in some cases slow 
progress, in others more rapid, — made a little worse and its step 
slightly quickened by every fresh cold, and finally results in ulcera- 
tion. The expectoration thenceforward becomes puriform, and finally 
undistinguishable from that of consumption, with all the symp- 
toms of which the patient finally dies. Indeed, before its nature was 
understood by the profession, it was considered the most fatal form 
of consumption, because it could be affected only in a very small 
degree, if at all, by medicines taken into the general system. 

Inflammation of Mucous Membrane and Glands of Larynx. 
Follicular Laryngitis. 

A FEW strong and beautifully formed cartilages unite to form a 
curious and convenient box or cavity at the top of the windpipe, 
called the larynx. Across this enclosure are stretched two remark- 
able cords, called the vocal ligaments. They are from half to three 
quarters of an inch in length, and are rendered more or less tense by 
the small muscles with which they are connected. Just above these 
cords are two cavities, which, with the ligaments, act an important 
part in the formation of the voice. Here is produced the sounds which 
is modified and articulated by the tongue, the lips, and the nasal cav- 
ities. 

When disease reaches this cavity, and the fluid secreted to lubricate 
these cords becomes acrid, the voice, from this and other causes, is 
made hoarse ; and when, at length, these ligaments are altered in 
structure by inflammation and ulceration, the voice suffers a gradual 
extinction. I have treated a large number suffering entire loss of 
voice, and am happy to say it has been generally restored, where the 
lungs have not been involved in the disease. There is often also a 
little sensitiveness, or even soreness, in some cases, in the region of 
the larynx, which may be felt by pressing upon that prominence in 
front of the throat, called Adam's apple. 



DISEASES OF THE THROAT. 193 



Inflammation in the Windpipe. — Tracheitis. 

This complaint and the one preceding it differ only in their locality 
from those described in the upper cavities ; and they are more alarm- 
ing, because two removes nearer the citadel of life. Happily, we know 
that the seat of these diseases may be easily reached, and we have a 
shower syringe, constructed by me in 1849, so arranged as t^ pour 
the remedial agent directly upon them, without any lacerating dis- 
turbance of th|p parts. 

Sjiuptoms. — The approach of these disorders is often so insidious 
as hardly to attract notice, — sometimes for months, or even years, 
giving no other evidence of their presence than the annoyance of 
something in the throat to be swallowed or hawked up, — an in- 
creased secretion of mucus, and a sense of wearisomeness and loss 
of power in the throat, after public speaking, singing, or reading 
aloud. At length, upon the taking of a severe cold, the prevalence 
of an epidemic influenza, or of an unexplained tendency of disease 
to the air passages and lungs, the throat of the patient suddenly 
becomes sore, its secretions are increased and rendered more viscid, 
the voice grows hoarse, the difficulty of speaking is aggravated, and 
what was only an annoyance, becomes an affliction, and a source of 
alarm and danger. These diseases clearly, belong to the family of 
consumption, and need early attention. 

Causes. — It is amusing to reflect upon the theories which writers 
were in the habit of constructing, a few years since, to account for 
the throat affection among the clergy. It was attributed by some to 
speaking too often, by others to speaking too loud. One class of 
writers thought it arose from high, stiff neck-stocks ; another, from a 
strain of voice on the Sabbath to which it was not accustomed on 
other days. 

The cause lies deeper than any of these trifling things. As it con- 
cerns ministers, it may generally be expressed in two words, — labor, 
anxiety. 

The clerical order are placed just where they feel the force of the 
high-pressure movements of the age. They are the only class of 
recognized instructors of adult men, and are obliged to make great 
exertions to meet the wants of their position. The extremely trying 
circumstances in which they are often placed, too, in these exciting 
times, by questions which arise and threaten to rupture and destroy 
their parishes, weigh heavily upon their spirits, and greatly depress 
the vital powers. And when we add to this the fickle state of the 
public mind, and the shifting, fugitive character of a clergyman's 
dwelling place, and the consequent liability to poverty and want to 
which himself and family are exposed, we have a list of depressing 
causes powerfully predisposing to any form of disease which may 
prevail. 

It wiU be pardoned me, I think, if I suggest here, that the nature 
of a clergyman's calling is of so serious a character, that he some- 

25 



194 DISEASES OF THE THROAT. 

times carries himself with too much sedateness, keeps himself too 
much braced up, and does not allow himself hours enough of that 
cheerful, light-hearted abandon, which is essential to the health of 
every sedentary man of 'mental habits. The hard-thinking and hard- 
working minister, who will retain his health, and save his throat, must 
have some moments, at least, when the weighty responsibilities of his 
office are lifted up from his soul, and he becomes, for the hour, the 
jocun^, playful boy of earlier days. How far he can consistently 
relax and let himself down, or in my view of the matter, raise him- 
self up to the simplicity and mirth of childhood, he aloiie can be the 
judge. As a physician, I prescribe ; as a minister, he must decide 
how far my prescription can be followed. 

Reading* Sermons. — There is one practice, which, though it has 
not much to do with inducing this disease, does frequently aggravate 
it when once established ; I mean the habit of reading sermons from 
manuscripts, — especially when it is done in a sort of mechanical 
way. Every person who has suffered from throat ail, has doubtless 
noticed that to read aloud, for half an hour, from a book, occasions 
more fatigue and irritation in the throat than extemporaneous speak- 
ing, in the same tones, for one or two hours. The reason is, that in 
the latter case the mind conceives the thought in season for the 
organs of speech to fall into a natural attitude, and utter it with ease. 
The two work harmoniously together, — the instruments of articula- 
tion following the mind, and easily and naturally uttering its concep- 
tions. Whereas in the case of reading, the mind itself is, at least 
partially, ignorant of what is coming until it is just upon it, so that 
the organs of speech, being warned of what is to be done only at 
the moment their service is required, do their work under a perpetual 
surprise and constraint. The difference is, in some respects, like that 
between walking freely at large, without regard to where the feet are 
put down, and being obliged to step exactly in the footprints of some 
traveller who has gone before. In the latter case, the muscles tire 
much sooner, because they work in fetters. 

I have thus spoken particularly of the clergy, though it is not by 
any means they only, but all classes of people who are afflicted with 
this dangerous malady. 

These diseases often begin with a cold. But colds are seldom 
taken except when the nervous system is depressed, so that they are, 
in fact, to be traced back to the same cause which I have assigned, to 
catarrhal or throat complaints themselves. 

These Complaints Worse at Xi^lit — It is worthy of note, that all 
these complaints, and many others, are worse during the night. This 
is easily explained when we remember that the atmosphere has the 
lerfst amount of electricity in it at three o'clock in the morning, 
and that the first minimum atmospheric pressure, which happens 
twice a day, occurs not far from the same hour. From three to four 
in the mornings therefore^ the nerve-power sinks to its lowest ebb ; and 
those diseases which owe their existence to anxiety, overwork, etc., 
suffer, at this time, their greatest daily aggravation. Death occurs, 



DISEASES OF THE THROAT. 195 

too, more often during these hours, than in any other portion of the 
twenty-four. 

Trentiiieut. — Some years ago these diseases were thought to be 
incurable ; and by all the appliances of medical art then known, they 
were so. But time has brought a successful method of treatment, as 
well as a clearer knowledge of their nature. 

This treatment consists in what is called topical medication, or the 
applying of the medicine directly to the diseased part. The medici- 
nal agent more extensively used than any other is a solution of 
crystals of nitrate of silver. This substance is not, however, adapted 
to eve?-!/ case, — other articles succeeding better in some instances. 
Modern chemistry has given us a variety of agents from which the 
skilful physician may select a substitute, should the nitrate of silver 
fail. 

The operation of applying this and other substances to the air 
passages, is a delicate one, requiring tact and experience. Surgeons 
had supposed it an anatomical impossibility to introduce an instru- 
ment into the larynx ; but this has been practically demonstrated to 
be a great mistake. 

Instnuiients. — The instrument devised and used by Dr. Horace 
Green is a piece of whalebone, bent at one end, to which is attached 
a small, round piece of sponge. This, dipped in the solution, is dex- 
terously introduced into the laryngeal cavity, and applied directly to 
the diseased part. 

I formerly used this instrument myself, and am happy to know, 
that notwithstanding its defects, it was generally successful. Yet 
where the larynx was highly inflamed, with a swollen and ulcerated 
condition of the epiglottis and lips of the glottis, I am sure I some- 
times had the singular powers of the nitrate of silver put at defiance 
by an irritation evidently produced by the sponge of the probang. 
Upon its introduction, in such cases, the parts contract upon and 
cling to it, and suffer aggravated irritation, almost laceration, upon 
its withdrawal, however carefully effected. 

Laryngeal Shower Syring:e. — Such defects in the probang led me 
to contrive an instrument, which I call a Laryngeal Shower Syringe. 
It is in the form of a syringe, the barrel and piston of which are made 
of glass, silver, or gold, as may be desired. To this is attached a 
small tube, made of silver or gold, long enough to reach and enter 
the throat, and bent like a probang, with a globe or bulb at the end, 
from a quarter to a third of an inch in diameter, pierced with very 
minute holes, which cover a zone around the centre about one-third 
of an inch in breadth. 

This silver bulb I daily introduce into highly inflamed and ulcer- 
ated larynges, generally without any knowledge of its presence on 
the part of the patient, until the contained solution is discharged. 
The instrument, being charged, is carried to the proper place, when a 
delicately quick pressure upon the piston causes very fine streams to 
flow through the holes in the form of a delicate shower, and all sides 
of the walls of the larynx are instantaneously bathed. 



196 DISEASES OF THE THROAT. 

How Introduced. — The introduction of this instrument into the 
larynx is easy. Upon the approach of any foreign substance, the 
epiglottis instinctively drops down upon the entrance to the larynx, 
guarding it against improper intrusions. It has been found, however, 
that when the root of the tongue is firmly depressed, this cartilage 
cannot obey its instinct, but stands erect, its upper edge generally 
rising into view. Availing himself of this, the surgeon has only to 
depress the tongue with a spatula, bent at right angles, so that the 
left hand holding it may drop below the chin out of the way, and as 
the epiglottis rises to view, slip the ball of the instrument over its 
upper edge, and then with a quick yet gentle motion, carry it down- 
ward diud forward^ and the entrance is made. I have often admired 
the faithfulness of this epiglottic sentinel, who, when overborne by 
superior force, stands bolt upright, and compels us to enter the sacred 
temple of speech directly over his head! 

Pliarvno'eal Shower SjTiiio'e. — For washing the upper part of the 
throat, I construct the instrument with a straight tube, with holes 
over the outer end of the globe, and extending to the centre. This 
washes instantaneously the fauces and pharynx, but does not throw 
the solution back upon the tongue. Its main advantage over the 
probang is, that it bathes every part of the fauces and pharynx in- 
stantaneously, and does not subject the patient to the coughing and 
gagging which follow the slower and rougher process of drawing the 
sponge from side to side across the cavity of the throat. 

iVasal Shower Syrmg;e. — Inflammations in the back passages to the 
nose, called catarrh in the head, have been almost inaccessible by any 
reliable healing agent, and consequently incurable. The probang 
cou*ld only reach a short distance^ and occasioned great suffering. I 
have had a syringe constructed with the tube bent at an angle of 
forty-five degrees, and the globe, very small, pierced with a few fine 
holes at the upper end. Carrying this globe up behind the velum 
palati, with a single injection I wash both passages clear through. I 
have had the pleasure of curing a large number of bad cases, of many 
years' standing, to the surprise and delight of the patients. 

About nineteen twentieths of the physicians who have examined 
these instruments, and so far as my knowledge extends, all who have 
used them, think them much better than the probang. As to patients, 
I have yet to see one who will allow the sponge to be used after try- 
ing both. 

Have Superseded the Probang. — In my own practice the syringes 
have superseded the probang altogether. My reasons may be briefly 
stated. I have already said there is less irritation produced. A piece 
of sponge drawn over an inflamed surface, especially when clung to 
by the irritated and quivering parts, must necessarily, in some cases 
at least, aggravate the symptoms of disease. To this consideration 
add the comfort of the patient during the operation. It is so quickly 
and delicately done with the syringe, that it is scarcely known when 
the act is performed. The straight syringe does not touch the throat 



DISEASES OF THE THROAT. 197 

at all. On touching the probang to the throat, the nitrate of silver 
unites with the mucus upon the surface, instantly covering the sponge 
with an albuminous pellicle, something like that which lines the shell 
of an egg, preventing, in a degree, the further pressing out of the 
solution, and rendering its contacts with other parts of the surface 
comparatively powerless. For this reason, the sponge pushed down 
into an ulcerated bronchus, as Dr. Green recommends, must be 
utterly valueless as a remedial agent. Mopping, as it does in its 
whole course, a larynx and trachea, lined in some cases with puriform 
matter, and generally with mucus, every inch of its descent doubles 
the gravity of this objection. Let it be considered, too, that in apply- 
ing the remedy to an ulcerated larynx, the sponge cauterizes the 
healthy parts above, in its descent, and thus unfits itself for doing 
much for the diseased part ; whereas the syringe retains its solution 
till it reaches the affected place, and then pours a clean shower di- 
rectly upon it, and upon no other part. 

Considering these manifest advantages of the syringes, I am sur- 
prised that any physician should still use the probang, — especially as 
one of these instruments, the Nasal Syringe, accomplishes an object 
which the probang cannot effect at all, not even in a rough way. I 
have wondered, too, how any parent can allow a child, suffering with 
croup, to be tormented by having a sponge pushed down its throat, 
when a syringe would give it so much less pain. 

The London Lancet. — It may as well be mentioned here, that in 
August, 1852, I put a neat set of these Syringes into a package, with 
one of my Tonsil Instruments, and sent them as a present to the 
editors of the London Lancet, accompanied by a brief note, expressed 
in as civil language as I could command, asking them to accept my 
small offering to the profession in England, and if they deemed the 
instruments of any value, to make them known. Seven months 
passed, and no private note acknowledged their reception. In April, 
1853, the Lancet contained an article under the head of " New Inven- 
tions," w^hich began by describing Dr. Green's Probang, then "Dr. Ira 
Warren's Shov^er Syringes, three in number, very neatly made, and 
contained in a neat case," and lastly, " Mr. Coxeter's Laryngeal 
Shower Syringe," which they pronounced the most convenient of all. 

From reading this article in the Lancet, no one would infer that 
either of the above syringes had any claim to paternity of the other. 
Dr. Ira Warren's residence, or even that he was an American, could 
not be learned from the article. And yet the facts are, that the editors 
put my syringes into the hands of Mr. Coxeter, who employed the 
seven months of their silence in getting up a miserable imitation of 
mine, which the editors call his invention, — saying nothing about his 
having stolen it from me, or the manner in which they abused private 
confidence in helping do it. 

The distal extremity of Mr. Coxeter's instrument is flattened from 
side to side. K the globe is retained and flattened, any mechanic can 
see that it cannot be as easily insinuated into the larynx as a perfect 
sphere. If the sphere is wholly removed, as the cut in the Lancet 



lOS 



DISEASES OF THE THROAT. 



seems to indicate, then the point is too sharp, and no prudent physi- 
cian would risk the chances of wounding the throat by its use. In 
any view of the case, there seems to be no better reason for the alter- 
ation than the desire to appear to furnish a new instrument, while in 
fact it is only mine a little altered for the worse. 

As to the rubber bottle at the other end, it is wholly unfit for the 
purpose intended. Its self-acting mode of charging the instrument is 
alone sufficient to condemn it. No sportsman who intends to bring 
down his game, would think of charging his piece by some self- 
acting machine which would be liable to draw in. twice as much, or 
twice as little powder as he desired. 

INlen who stand, like the editors of the Lancet, at the portals of 
professional opinion, should be men of large souls, who are disposed 
to give any new thought or instrument that comes to them, clear 
papers of " safe conduct," to travel anywhere, — to fame or to 
oblivion, — without improper molestation, especially without d. seven 
months' imprisonment. 

The truth is, that in the construction of ships and boats, locomo- 
tives, farming implements, several kinds of machinery, surgical in- 
struments, etc., the Americans are in advance of the English. While 
it is clear that the latter are slow to acknowledge this, I did not sup- 
pose any respectable Englishman would resort to anything deceptive, 
with a view to appropriate what belongs on this side the water. 

Several parties in this country have got up imitations of these 



syringes, and have made them- 
selves liable for damages under 
the patent ; but they are persons 
of little or no responsibility, and 
I have not as yet brought the 
law to bear upon them. Those 
who purchase and use these imi- 
tations, should bear in mind that 
they are also liable for damages, 
as they lie in a case. 



Fig. 84. 



[Patented December 6, 1853. 




Figure 84 represents these syringes 



Mode of Usin^. — The glass barrel and piston of my instruments 
are delicate, but they need not be broken. I handle them with the 
same ease that I do a spoon in feeding myself, and not in a very dis- 
similar way. The last three fingers are placed on the under side of the 
barrel, with the thumb on the upper side, — the index finger being 
poised over the end of the piston, ready to drive it home at the proper 
instant. The motion of the piston should be quick^ so as to cause 
the streams to leap out in jets ; yet delicate^ that they may not im- 
pinge with too much force upon the diseased surfaces. 

They should be rinsed with water immediately after being used. 
But even with this precaution, a small residuum of the nitrate re- 
mains and crystallizes, and after a time partially closes the holes. 
They must then be picked out with the point of a needle. 

When the silver tube becomes detached from the glass, it may be 
fastened on with common sealing wax ; first melting the wax and 



DISEASES OF THE TIIKOAT. 199 



sticking it around the glass ; then heating the silver over a lamp, and 
pressing it on. 

Aiiioiiut of Solution to be Used. — The amount of solution to be 
used should be small. Half a dram is enough. The piston of the 
syringe need be drawn up only from an eighth to a third of an 
inch. Strangling is not often produced by these operations ; but to 
make its prevention still more sure, let the patient be directed to fill 
the lungs with a long inspiration while the operator is depressing the 
tongue. 

Streiio'th of Solution. — The strength of the solution in ordinary 
cases of chronic folliculitis, etc., should genemUy be about forty grains 
of the crystals of the nitrate of silver to the ounce of water. But 
in all acute diseases of the air passages, it should be considerably 
stronger, — varying from one to two drams. A preparation of this 
strength is powerfully antiphlogistic and sedative. In those cases of 
chronic disease, where the inflammation is of a low grade, and the 
mucous membrane is in a relaxed, atonic condition, looking either 
sodden and pale, or of a dark color, like the cut surface of beef, some 
days exposed to the air (as is often the case in throats of literary dys- 
peptics), then a solution of fifteen to thirty grains to the ounce, is 
sutficient. This strength acts as a stimulant, and is well suited to 
throats in such condition, but would be injurions in high grades of 
inflammation. Catarrh in the head generally requires only about this 
strength. I am sorry to say, the topical mode of treating throat aflec- 
tions has been in some places injured, in the public estimation, by a 
lack of knowledge and judgment on the part of the operator, in choos- 
ing the strength of his solution. 

To determine the proper frequency of the operation^ also requires 
judgment and experience. In an ordinary case of chronic disease, 
the treatment may begin by showering the throat once a day for a 
week. Then the operation should be repeated three times a w^eek, 
for a shorter or longer period ; then twice a week, and at last once a 
week. 

Attendant Diseases. — Among the persons lam treating for diseases 
of the air passages, many are dyspeptic and suffer with depression of 
spirits. So often does this symptom present itself, that I regard it as 
almost one of the peculiarities of throat disease. Persons thus de- 
pressed generally have the dark and dingy look of the face which 
indicates functional derangement of the liver. They are often ema- 
ciated, nervous, hypochondriacal, irritable in temper, and are ex- 
hausted by an excessive secretion of urea. The urine of such per- 
sons is always acid, and loaded with crystals of oxalate of lime. 

An explanation of this fact has been attempted, by supposing that 
the oxydation of carbon (of which these persons have a superabun- 
dance), imperfectly accomplished in inflanjed respiratory organs, is 
vicariously effected in the capillaries of the kidneys, — oxalic acid 
(C2. 02.) instead of carbonic acid (C. 02.) being the result. 

The crystals of oxalate of lime are octahedral in form, and, in the 
field of a good microscope, are beautiful objects for inspection. 



200 



DISEASES OF THE THROAT. 



Lawyers, clergymen, statesmen, and, in general, those who labor 
hard mentally, with but little bodily exercise, and who have a great 
weight of care resting on them, are the persons who suffer most from 
this complication. Generally, the inflammation in the throat is of a 
low grade, and must not be treated with a very strong solution of 
nitrate of silver. 

Of course when these attendant diseases exist, something more is 
needed than the local treatment. For the troubles just described, the 
treatment for hypochondria and dyspepsia will be proper. 

Elongation of the Uvula. 

The uvula is the small teat-like or pendulous organ which hangs 
down from the palatine arch, just over the root of the tongue. Jt is 
very apt to get inflamed, and its parts becoming relaxed, it stretches 
out lengthwise, so that its lower extrem- ^^^ g^ 

ity sometimes rests upon the tongue. 
(Fig. 85.) When this happens, it flaps 
about, backward and forward, and to 
the right and left, — touching the throat 
at various points, and by the tickling 
sensation produced, exciting a most in- 
cessant, uncontrollable, and racking 
cough. Some of the most distressing 
coughs I have ever heard, have been 
produced and kept up by this cause 
alone. Many a fatal consumption has 
begun in this way. When long in- 
flamed, it often gets much out of shape, 
being sometimes bent nearly double. 

Treatment. — In some cases, the uvula, 
thus elongated, may be reduced back to 
its natural size, by an astringent gargle, 
composed of an infusion of white-oak 
bark, with a little alum dissolved in it 
(232) ; .but it will generally stretch out 
again and again, upon the appearance 
of any fresh cold, and, therefore, the 
only certain cure is to cut it off". 

To do this, take hold of it with a pair 
of common forceps, and having stretched 
it down a little, clip it ofl" above the 
forceps, with a pair of curved scissors. 
Nearly the whole of it should generally be removed. To take ofl" a 
part only, leaves a stump, which is often more objectionable than the 
whole organ. Its removaj never injures the speech in the least. In 
many cases of nasal catarrh, this organ is a sort of diseased centre, 
from which the inflammatory action spreads upward into the nasal 
cavities, and no medicine or power on earth can effect a cure until 
this offending member is snipped off. 




DISEASES OF THE THROAT. 201 



Acute Inflammation of the Tonsils. — Tonsilitis, 

The tonsils are chiefly a collection or mass of small mucous folli- 
cles or glands. They secrete a portion of the fluid which keeps the 
throat moist. 

There is a class of persons who suffer about every winter, some- 
times oftener, with an attack of acute inflammation of these glands, 
which causes great suffering for several days. The trouble begins 
with a slight soreness and swelling in these glands, which gradually 
increase until the mouth can scarcely be opened, and the act of swal- 
lowing is attended with indescribable suffering. At length, in from 
four to ten days, an abscess forms and breaks in one or both glands, 
which produces immediate relief. 

Treatment, — The inflammation may sometimes be cut short by 
thrusting a lancet into the tonsils, and bleeding them freely, and then 
steaming them by the inhalation, by means of an old teapot, of the 
steam of mullein leaves and hot water. But the only cure is to be 
found by cutting off" the tonsils, after the inflammation has subsided. 
This will put an end to the attacks at once. 

Tonsils which are subject to these periodical attacks of acute inflam- 
mation are always more difficult than others to operate upon, as they 
are almost invariably bound down very tight to the throat, and cannot 
be raised up for convenient excision. 

Chronic Inflammation of the Tonsils. 

In many of the fallicular diseases of the throat, these glands are 
affected by a chronic inflammation, and are found enlarged, and 
sometimes very much hardened. In such cases they secrete a thin, 
unhealthy, irritating, fluid, which is spread over the throat, increasing 
and perpetuating its disease. Much of this secretion, finds its way 
into the stomach, and thence into the circulation. 

In the throats of many young persons and children, these glands 
are permanently so large, as nearly to fill the fauces. The respiration 
of many children thus afflicted, is difficult, and when asleep they can 
only breathe with the mouth open. The defective breathing of such 
children often occasions contraction of the chest, and thus lays the 
foundation for consumption. From these diseased parts, the inflam- 
mation often spreads upwards, into the posterior nares, and many 
times enters the eustachin tubes, causing deafness or pain in the ears. 
Such children often breathe as though they had a bad cold in the head. 
Their health and safety require an immediate attention to this state 
of things. 

Treatment, — It is customary to attempt to reduce enlarged tonsils 
by astringent gargles, by repeated applications of a solution of nitrate 
of silver, and by other remedies, and particularly by brushing them 
over with the tincture of iodine. As a general thing, these applica- 
tions are useless, ending in disappointment. As with the elongated 

26 




202 DISEASES OF THE THROAT. 

uvula, the remedy is found only in excision. Cut them off. The 
throat seldom gets well until they are removed. The speediness of 
the recovery after the removal is often surprising. 

Improved Tonsil Instrument, — For the excision of these glands, I 
found the same lack of instruments as for making topical applications 
to the throat. The only one which had any claims to regard, was 
the guillotine instrument. It had, however, no facilities for drawing 
the tonsil forward. Generally, all that could be done with it, was, to 
trim the gland, which did little good, for it became again enlarged. 
I have prepared an entirely original instrument, with which the extir- 
pation of these glands is easy and expeditious. It has two cutting 
blades in the shape of crescents, fig. 86. 

which, when open, leave a [Patented January 17 , 1854..] 

proper space for drawing the 
tonsil between them. . Two pol- 
ished guards which I formerly 
had made of steel, but now of 
German silver, protect the upper 
and the under surfaces of the 
crescentic blades, and running back, are fastened by the common 
rivet, which holds together the shanks, so that, when open, the blades 
are concealed under the guards. The tenaculum rests upon the rivet, 
as upon a fulcrum, and, dipping between the blades, takes hold of the 
tonsil, and draws it up for excision. Cutting, as these blades do, the 
entire circumference of the gland first, and at the same instant, and 
the central portion last, the operation can never fail. The entire ton- 
sil, even when much hardened, is swept off with a cleanness and ease, 
which, at the first trial, surprises the operator not less that the patient. 
The pain of removing these glands is so trifling, as scarcely to be 
thought of ; and the pretence that evil consequences follow their re- 
moval, is the offspring of great ignorance of the whole subject. 

To operate easily, take the instrument in the right or left hand, ac- 
cording to the side to be operated upon ; take the forceps in the other 
hand, and running them through the open blades, into the mouth of 
the patient, take firm hold of the tonsil ; then slide the instrument 
down over the forceps, and lifting the gland up between the blades, 
cut it quickly off'. 

I am aware that a few irregular practitioners, who stand outside 
the profession that they may act without responsibility, have declared 
that mischievous results follow this operation upon the tonsils. Their 
reasons for so declaring are manifest. They have never performed 
the operation, and have not the skill to do it if they would. They 
expect, too, that those nervous persons who dread the operation, will, 
when told by a physician that it is necessary, strive to evade it by 
seeking their advice. Such practitioners are shrewd, but neither 
honest nor wise. They defeat their own purpose in the end. I have 
again and again had patients leave me when this operation was 
urged upon them, and finally return and submit to it, after nearly 
losing their lives in the hands ^of dishonest quacks. A few of these 



DISEASES OF THE THROAT. 203 

practitioners have taken the same course in regard to the use of ni- 
trate of silver, and for similar reasons. 

Ciu'ability of Throat Diseases. — I have dwelt somewhat upon the 
preceding forms of throat disease, not so much because they have 
been a speciality with me for the last ten years, as because they pre- 
vail to a fearful extent, and are, in thousands of cases, but the first 
stages of fatal disease of the lungs. 

If not connected with lung disease in the beg-inmng-, my experience 
in treating them enables me to say, emphatically, they are generally 
curable. 

But patients often put the question to me, — " If cured, will I ever 
have the complaint again ? " My answer is, — " Unless I can plant 
in your constitution a better protection than your Maker put there at 
your creation, you will of course be liable to a second attack." But 
then, where the lungs have been entirely free from disease, I have 
never yet seen a case of simple throat complaint relapse and become 
dangerous after proper treatment with the syringes. Let not those, 
therefore, who have been benefited, but not entirely cured by this 
treatment, undervalue what has been done for them. Even in such 
cases, the advantage derived to them amounts to just the value they 
attach to — the continuance of life. 

Dang'ers of Delay. — In closing these remarks, let me warn the 
reader against the dangers of delay. Many of those who finally seek 
my services in these complaints, first try all nostrums, and tamper 
with their disease till the case is either critical or hopeless. Too 
many wait till they are near enough to the engulfing whirlpool to 
hear it roar, before they seek in any practicable way to escape its 
dangers. 

Scarce a day passes but cases come into my hands which at first 
were only a slight inflammation of the pharynx, and might have been 
cured in a few days, but which, from long neglect, has gradually crept 
down the windpipe, spread over the widely distributed mucous lining 
of the bronchial tubes, and thus become curable only in a partial de- 
gree, and after long and tedious treatment. Hundreds of persons in 
this city, and thousands in New England, are now suffering from 
slight attacks of this sort, who might be rid of the affliction in a week 
or a fortnight, but who will either carelessly give it no attention at 
all, or resort to useless nostrums, until it has run through its primary 
stages and invaded the constitution, and will finally die of some of 
the forms of pulmonary disease. 

Cases*Treated. 

In July, 1852, Professor ■ of-W , Mass., a distinguished 

teacher and composer of music, called on me to obtain relief from 
laryngitis and tracheitis, from both of which he was suffering, in con- 
nection with bronchial and pulmonary irritation. A year previous to 
this, his health had suffered a general break-down from these com- 
plaints. He had soreness in the larynx and trachea ; a severe cough 



204 DISEASES OF THE THROAT. 

and large expectoration ; he had hoarseness, with inability to sing ; 
night sweats ; emaciation ; general debility and lowness of spirits ; 
in short, the whole catalogue of symptoms which indicate impending 
bronchial consumption. By advice of physicians and friends, he went 
to Europe and travelled extensively. Finding no relief, he pushed on 
to Africa. On reaching Cairo, his disease showed the first abate- 
ment. Remaining here a few weeks, he found himself, as he thought, 
about well. But on reaching Europe, upon his way home, his cough, 
with all his other bad symptoms, returned, and after a year's weary 
search for health, he came to the wharf at Boston in about the same 
condition as when he left. It was at this moment, that, disheartened, 
and expecting to die, he picked up the Evening Traveller, the first 
paper that met his eye, and saw an article on throat diseases, which 
brought him to my office. Fortunately, before his departure for 
Europe, Mr. had bought a farm in W . I gave him an in- 
strument, with the proper medicines to inhale, and directed him to 
work every day on his farm, to the extent of his physical ability, and 
to come to me three times a week to have the larynx and windpipe 
showered with a solution of nitrate of silver. These directions, with 
others relating to his general health, he followed to the letter. It is 
enough to say, that all his bad symptoms gradually subsided, and 
upon the approach of the following winter he found himself nearly 
recovered. In accordance with my advice, however, he abstained 
from professional labor until the following spring, since which time 
he has pursued his calling diligently. 

In 1853, Mr. , a merchant of this city, came to me with two 

enormously enlarged and hardened tonsils, with which he had been 
afflicted for a long time. One of the glands had been operated on five 
times, the other eleven times, by one of our best surgeons. But the 
old guillotine instrument used was not large enough to permit either 
gland to be drawn into it, and only small pieces could be shaved off. 
The consequence was, that they were made no smaller by the opera- 
tions ; and being often cut, they were hardened by it, and had taken 
a very obstinate form of disease, so much so, that the patient, though 
naturally a strong man, was seriously threatened with pulmonary dis- 
ease. He had travelled much during the preceding summer, but was 
in no way improved by it. I had a large instrument made expressly 
for the purpose, through which the glands could be easily drawn, and 
cut them both through the centre, or root, removing one half. A 
solution of nitrate of silver, fifty grains to the ounce, was applied to 
the throat three times a week, for about a month, at the end of which 
time, the patient was dismissed well, and has remained so to the 
present time. 

In February, 1852, anotlier merchant of this city, Mr. J. A- 



came under treatment for a well-marked case of follicular disease, 
with nasal catarrh and bronchitis. Indeed, the lungs were on the 
point of becoming a prey, as a fine rattle was plainly distinguishable 
at the top on both sides, and blood was raised at various times. 



DISEASES OF THE THROAT. 205 

The uvula first being excised, the whole throat and nasal cavities 
were showered from two to three times a week, for two or three 
months, every bathing bringing away, during the first part of the 
treatment, enormous quantities of tenacious, ropy mucus. To this 
treatment, with inhalation, and constitutional remedies, the disease 
yielded slowly but surely, and Mr. A. has a good prospect of pursuing 
his profession in comfort to old age. 

In February, 1857, I was inquired of respecting the prudence of 
undertaking to get a young man to Boston from one of the northern 
towns of New Hampshire, who was supposed to be rapidly sinking 
in consumption. After hearing the case described, I decided it to be 
a safe undertaking. Though feeble, he came safely in two days. 
He had the most incessant, tearing, and destructive cough, I ever 
heard. The moment I heard its peculiar sound, I suspected the 
source of the trouble ; and, seating him in a chair, I opened his 
mouth, and found the uvula enlarged to a size, and stretched down to 
a length, which I had never witnessed before. It was lying down 
upon the tongue, as in cut 85, which is a good representation of it. 
Without giving him any notice, I took the forceps and scissors, and 
cut it off, the whole of it. I told him to go to his hotel, and come 
to me the next morning. He entered my office the next day, cheer- 
ful and laughing, saying he had not coughed any all night, and had 
slept well, — a thing he had not done for several months. In two 
weeks, he could walk three miles, and I sent him home well. But 
for the operation, he would have died within six weeks. 

I would be glad to add a great number of cases to the above ; but 
^these are all for which I have room. 

A Cold.— Influenza. 

A SLIGHT attack of the disease about to be described, affecting only 
here and there a person, and lasting only for a few days, is called 
a cold. When it affects a large part of the community at the same 
time, lasting many days, or evan weeks, it is then an epidemic, and 
passes under the name of influenza. In this latter form, it sometimes 
spreads over a whole country, and has at times, as in 1832, extended 
to nearly the whole civilized world. It often shows marked severity 
in its progress, and leaves serious results behind. 

Symptoms. — A tingling, with dryness, and a sense of fulness in 
the mucous membrane of the nose, are among the first indications of 
an attack of this complaint. Sneezing is a common symptom. Soon, 
pain is felt in the forehead, and breathing through the nose becomes 
difficult. The eyes are red and watery, the throat is sore ; there is a 
dry cough, hoarseness, thirst, general lassitude, chills, and a desire to 
get near the fire. The mucous membrane of the nose, throat, wind- 
pipe, and breathing tubes, is inflamed, red, swollen, and sometimes 
painful. 

In a short time, water begins to run from the nose and eyes, and 



206 DISEASES OF THE THROAT. 

the cough becomes a little more moist. T'here is also a slight dis- 
charge from the throat and tubes, which gradually increases, and, at 
length, as the disease declines, and becomes less acute, the expectora- 
tion is thick and yellow. 

Aching of the back and limbs, thirst, loss of appetite, flashes of 
heat, and chills whenever the patient is exposed to air a little cooler 
than he is accustomed to, are almost constant attendanj:s upon the 
disease. 

Causes. — It is not always easy to say what the causes of this com- 
plaint are. Frequently, it can be traced to an improper exposure to 
cold or dampness ; but in a great majority of cases, especially when 
it takes the form of influenza, the causes are not obvious. They 
probably exist in some peculiar states of the atmosphere, and in a 
depression of the nervous system. 

The influence upon disease of the different degrees of density in 
the air which surrounds us, and of other circumstances affecting it, 
have not been much studied. Some valuable facts w^ill be drawn 
from this source before many years. The putting upon the body, or 
taking from it, several tons of pressure every time the barometer rises 
or falls, must have, of itself, no small influence upon its health. The 
comparatively new science of Physical Geography, by spreading be- 
fore us its interesting facts in regard to temperature, storms, atmos- 
pheric currents, etc., is opening the way for the physician to learn a 
great deal more about the causes of disease than he now knows. 

Treatment, — In mild cases, only the most simple treatment is re- 
quired, — such as remaining in the house for a few days, soaking the 
feet in warm water, taking a gentle- sw^eat, drinking warm infusion^ 
of flax-seed, mullein, slippery elm, or warm lemonade, and taking 
only a spare vegetable diet. If the bowels be costive, some gentle 
physic (34) (41) may be used. A laxative drink (132) will likewise 
be useful. 

When the attack is more severe, sweating must be induced by de- 
cisive measures. This may be effected by the spirit vapor bath, or 
by putting the patient in bed, putting bottles of hot water to the feet 
and sides, and administering warm drinks, and the compound tinc- 
ture of Virginia snake root. Five drops every hour of the tincture 
of veratrum viride, will often cause very free perspiration, and will 
reduce the inflammation upon the mucous surface. 

An emetic is sometimes very useful. To produce vomiting, use 
the powder of ipecac, ten to twenty grains, or the compound tincture 
of lobelia. 

It soothes the inflamed mucous surfaces very much to inhale the 
vapor from half a pint of hot water, with five drops of tincture of 
veratrum viride, or the same amount of the tincture of aconite root. 

If the cough is severe, use the preparations recommended under 
bronchitis and consumption. 

In the latter stages of the disease, if there be debility, — as there 
generally is, — quinia, iron, nux vomica, etc. (75), should be taken ; or, 
to support the nervous system, the extracts of scullcap, and boneset, 



DISEASES OF THE THROAT. 207 

and the sulphate of quinia (81) will be found useful. At this stage 
of the complaint, the diet should be more liberal and nourishing. 

The patient should not venture into the open air, until the unpleas- 
ant sense of chilliness, peculiar to the disease, ceases to be produced 
by exposure. 

Acute Inflammation of the Epiglottis. 

This is the disease by which our country lost its most loved and 
distinguished citizen, George Washington. This complaint was not 
understood at the time of his death, — the intelligent physicians who 
attended him, supposing it to be inflammation of the windpipe. From 
their very clear description of the symptoms, we now know it to have 
been an acute inflammation of the epiglottis and glottis. 

From the rapid inflammation of the epiglottis, water is effused into 
this cartilage, so as to pufl" it up, and prevent it from shutting down 
in the act of swallowing. The lips of the glottis are swollen from the 
same cause, and brought so near to each other that air passes through 
to the lungs with great ditficulty, and unless relief is soon obtained, 
the patient is strangled. 

Symptoms. — The disease begins with a severe chill, accompanied 
with some pain, and a sense of stricture or tightness in the upper 
and fore part of the throat. There is cough, with difficult and some- 
times painful swallowing. These symptoms are soon followed by 
quick and laborious breathing. Speaking aloud is from the first diffi- 
cult, and soon becomes impossible. As the complaint runs its rapid 
course, the breathing grows more diffSlcult, and death soon results 
from complete strangulation. 

Treatment. — Apply immediately to the parts, a strong solution of 
nitrate of silver. The solution should be of the strength of ninety 
to one hundred and twenty grains to the ounce of soft water. It 
should be applied every hour or two till the feeling of suffocation sub- 
sides, and should be done with the laryngeal shower syringe, though 
if this is not at hand, the sponge probang may be used. 

While this local treatment is being employed, liberal doses, from 
five to twenty drops of tincture of veratrum viride should be given 
every hour, watching the effect, and discontinuing when the pulse 
sinks too low. 

Hot fomentations applied externally, and filling the room with 
steam, as recommended in cases of croup, would be useful. 

Mum*ps. — Parotitis. 

This disease appears most often among children ; but as it is not 
confined to them, I have not placed it among their complaints. 

Symptoms. — It begins with soreness and stiffness in the side of the 
neck. Soon a sweUing of the parotid gland takes place, which is 
painful, and continues to increase for four or five days, sometimes 



208 DISEASES OF THE THROAT. 

becoming very large, and making it difficult to swallow, or open the 
mouth to receive food. After the fourth or fifth day the swelling 
subsides, and disappears in from seven to ten days. 

Both glands generally swell about the same time, but sometimes 
the swelling appears in one only after it has subsided in the other, 
and occasionally the swelling is wholly confined to one side. 

When the swelling is great, there is heat, and sometimes fever, with 
dry skin, quick pulse, furred tongue, constipated bowels, and scanty 
and high-colored urine. 

The affection is sometimes translated, as we say ; that is, in fe- 
males, the breasts swell, and in males, the testicles become swollen 
and painful. This accident generally happens in consequence of tak- 
ing cold from some imprudence. 

The disease is contagious ; that is, it is communicated from one 
person to another. 

Treatment. — In mild cases, very little treatment is required. Keep- 
ing the face and neck warm, avoiding exposure to cold and damp, 
drinking warm infusions of balm, spearmint, or sage, and taking oc- 
casionally, if there be some severity of symptoms, four to six grains 
of Dover's powder ; or the compound powder of jalap, if there be 
costiveness, is about all that is required. The diet should consist of 
rye hasty pudding, or brown bread and sweetened water. 

If the case be severe, and other glands swell, physic must be freely 
used, leeches must be applied, and cooling lotions, or poultices. 
Sweating must also be induced by the compound tincture of Ver- 
ginia snake root, or by a vapor bath. 



DISEASES OP THE CHEST, 



Consumption. — Phthisis. 

At the head of the diseases of our climate stands Consumption, — 
at their head both as it respects prevalence and fatality. Small pox, 
yellow fever, and cholera, are terrible in their visitations ; but what 
are all their aggregated slaughters compared with the ceaseless, silent 
march of this fell disease, which steals away in their fresh prime the 
brightest and the best ? 

Boston, from its population of 160,000, loses by consumption about 
fifteen per week, sixty-five per month, or about seven hundred and 
eighty per annum. An equal mortality from any disease not often 
among us, would send our citizens in terror to the country, and cause 
the stoutest hearts to feel that " in the midst of life we are in death." 
Massachusetts loses about 6000 per annum ; New England, hot less 
than 20,000 ; *and with the State of New York added, the victims of 
this single disease swell to 40,000 a year! What an army! Picked 
from the choicest ! All sundered from life untimely, and leaving 
more blight and sorrow behind than would perhaps twice or thrice 
the number whom any other pestilence w^ould have selected. The 
magnitude of the evil places the question of the remedy before all 
others that pertain to the healing art. 

Methods of Examinino' the Chest. — Before speaking further of con- 
sumption, I propose to do what has never been done, namely, to 
instruct the general reader, very briefly, in the method of examining 
the chest to learn the existence of disease. Perhaps this will be con- 
sidered a departure, in some slight degree, from my purpose to make 
this entire book intelligible to the general reader. If so, my reply is, 
that there are mani/ school teachers, mechanics, masters of vessels, 
and farmers, who have inquiring minds, and sagacity enough to learn 
the physical signs of chest disease, and to make them, in many cases, 
practically useful ; and that even readers of little reflection cannot 
fail to comprehend a portion of my explanations. 

Position of the Patient. — In performing percussion upon the front 
of the chest, the patient should be required to sit in a square position, 
with the arms hooked over the corners of the back of the chair, and 
the head thrown a little back. 

27 



210 



DISEASES OF THE CHEST. 



Instrument with which to Thunip. — The index and middle fingers 
of the right hand are to be brought together, into a line, and used as 
the percussing instrument. The blow given with these is to be smart 
and quick^ rather than heavy. 

Medium to Thump Upon. — Either the index or middle finger of 
the left hand is to be pressed firmly upon the su^jj^ice of the chest to 
be percussed or struck, and thus used as a pleximiter. 

Auscultation. — Listening for the purpose of hearing within the 
chest the sounds produced by breathing, talking, coughing, etc., is 
called auscultation. 

Instruments with which to Listen. — The naked ear is generally 
considered best for hearing low and delicate sounds ; but for hearing 
loud and rough ones, it is not so good as the stethoscope, repre- 
sented by Fig. 87. A still better instrument is the double-eared steth- 
oscope, Fig. 88. It magnifies the sounds very much, and is apt to 
confuse an examiner not accustomed to it ; but when the ear is once 
familiar w^ith it, the aid it affords is very valuable. 



Fig. 87. 



Fig. 





The examiner should pass from side to side, continually comparing 
the sounds upon one side, with those upon the other. 

The patient must be calm, and the examiner in no hurry. 

Healthy Sounds, — To become skilful either in percussion or aus- 
cultation, the examiner's ear must first be trained to healthy sounds. 

These are best heard in the child, in whom they are louder than in 
the adult. 

In describing the healthy sounds in the different regions of the 
chest, I shall refer the reader constantly to Figs. 89 and 90. 

Clavicular Region. — This, in Fig. 89, is represented by 1, 1. Upon 
thumping upon the collar-bones, the sound given out at the breast- 
bone end should be very clear ; less clear in the middle ; and dull at 
the shoulder end. 



DISEASES OF THE CHEST. 



211 



Subcla™n Region. — This is represented by 2, 2, and lies between 
the collar-bone and the fourth rib, on both sides. It covers a consid- 
erable portion of the upper lobe of the lungs. The sound upon strik- 
ing this space should be very clear. 

FiQ. 89. Fig. 90. 





Tlie Mammary Region, represented by 3, 3, extends from the fourth 
to the seventh rib, on each side. In the upper part^of this region, the 
healthy sound is clear ; but at the bottom of it, on the right, the 
sound is deadened by the liver ; on the left, by the heart. 

The Iiifra-Mammary Region, 4, 4, lies between the seventh rib and 
the edge of the cartilages of the false ribs. On. the right side, the 
liver makes the sound dull ; but under the left side lies the stomach, 
which is hollow, and the sound is generally quite loud. 

In the Sternal Region, 5, 6, 7, which covers the breast-bone, the 
sound is generally clear. 

The Axillary Region, 8, 8, is in the arm-pits. In this the sound 
should be clear. 

The Lateral Region, 9, 9, is immediately below the above, and 
yields, likewise, a clear sound. 

The Lower Lateral Region, gives a dull sound on the right side, and 
on the left a very hollow one. 

Fig. 90 represents the back part of the chest. In looking at this, 
we see the 

Acromial Region, represented by 11, 11. In this space the sound 
is dull, but it has not much meaning. 

The Scapular Region, 12, 12, covers the part occupied by the shoul- 
der-blades. It gives rather a dead sound. 



212 DISEASES OF THE CHEST. 

The Iiltra-Scapulrtr Region, 13, 13, lies between the shoulder-blades, 
on each side of the back bone. If the patient's arms are crossed, and 
the head bent forward, a clear sound will be obtained. 

The Dorsal Region, 14, 14, covers the base of the lungs, and, in 
health, gives a clear sound. 

Observation. — If, now, on thumping upon the chest, we find a dull, 
dead sound in any spot where a clear one ought to be yielded, we are 
to conclude that underneath there is not the usual quantity of air ; 
but we cannot tell merely by percussing, whether tubercles are depos- 
ited there, or the lung has become solid by inflammation, or water 
has been poured out into the cavity of the pleura. This point must 
be determined by auscultation, etc., to be explained gradually as we 
go along. 

Auscultation of Breathing. — On applying the ear or the stetho- 
scope to the chest, two sounds are heard which immediately succeed 
each other, — the louder is produced by the ingoing breath, or inspira- 
tion ; the weaker by the outgoing breath, or expiration. These sounds 
will be further explained as we go along. 

Auscultation of the Voice and Cough. — The chest of a healthy per- 
son speaking, communicates to the ear no distinct sound, but only 
a vibratory sensation, called, in technical language, the pectoral fre- 
mitus. 

Over the larynx and windpipe, the examiner may hear natural pec- 
toriloquy ; between the shoulder blades, in the space corresponding to 
the roots of the lungs, natural bronchophony. 

Philosophy of Chest Sounds. — The fulness and clearness of sound 
upon percussion, depends upon the amount of air in the chest. 

The sounds called breathing murmurs^ are caused by the expansion 
and contraction of the air-cells or vesicles, as the air passes in and 
out ; hence they are called vesicular murmurs. 

The friction of the air against the sides of the windpipe and large 
bronchial tubes, causes the blowing sound heard in those parts. 

In children a larger amount of air enters the lungs, and the air vesi- 
cles are expanded with more force ; hence their breathing has a louder 
sound, which is called puerile respiration. This kind of breathing, 
heard in the grown person, is a sign of disease. 

The lung tissue is a bad conductor of sound ; and the voice is ac- 
cordingly heard only over those parts where large bronchial tubes are 
near the surface ; heard elsewhere, it indicates disease. 

Division of Consumption. — Consumption may be divided into two 
kinds, the tubercular and the bronchial. The former has a constitu- 
tional, the latter a local origin. 

First Stage of Tubercular Consumption. 

Physical Signs. — Dulness of sound on and under the collar-bones. 
Inspiration shortened ; expiration augmented both in duration and 
intensity. ^ . 



DISEASES OF THE CHEST. 213 

Occasionally a pulmonary, crumpling sound. Dry, crackling rat- 
tles. 

The resounding of the voice increased at the top of the lungs. 

General Symptoms. — A sense of weariness and languor. 

Occasionally, slight, flying pains about the chest and shoulders. 

A peculiar sensitiveness to the effects of cold. 

Breathlessness on moving quick, or ascending a hill or stairs. 

In many cases a blue lividity of the lips, and roots of the finger 
nails, and coldness of the hands and feet. 

Occasionally, in females, even at this early stage, a cessation of the 
monthly turns. 

Observations. — The formation of tubercles almost always begins 
at the top of the lungs. Laennec and others thought they appeared 
oftenest on the right side first ; Louis, Andral Watson, Sir James 
Clarke, and others, believed they appeared more often on the left side. 
Recent investigations show that they were all mistaken. Tubercles 
appear first about as often upon one side as upon the other. 

The pulmonary crumpling sound is caused by a mechanical ob- 
struction to the expansion of the lungs. It is generally heard only 
during the drawing in of the breath. The sound is like that pro- 
duced by blowing upon very fine paper. 

Second Stage. 

Physical Si«*ns. — Marked dulness of sound on the collar bones, and 
extending below them. 

Inspiratory murmur diminished in duration and intensity ; expira- 
tory murmur augmented in both. 

In upper lobes of lungs, moist, crackling rattles, succeeded by mu- 
cous rattles. Also bronchial respiration. 

In lower lobes of lungs, puerile respiration. 

Sounds of the heart heard under the collar bones. 

Bronchophony heard in the same parts as bronchial respiration. 

General Sjniptoms. — A quickened pulse ; slight fever towards 
evening. 

Great susceptibility to the effects of cold, and liability to take cold 
easily. 

Bowels generally costive. 

The eye has a peculiar whiteness and lustre. 

The skin and mouth become dry in the afternoon ; chills occur 
about midday, followed by fever, during which the cheeks are flushed. 

As the second stage advances- to its close, a dry, burning heat 
afflicts the palms of the hands and soles of the feet. 

Night-sweats occur at this time. 

ObseiTations. — A hollow, elastic body, containing air, gives, when 
struck, a clear sound. The dulness of sound on percussing the chest, 
arises from the absence of air in the air-cells, — these having been 
pressed together, or obliterated by the deposit of a mass of tubercles. 



214 DISEASES OF THE CHEST. 

The destruction of these cells causes the cessation of the respiratory 
murmur. 

This stage of the disease is often accompanied by an inflammation 
of the mucous membrane lining the air tubes. The air, pushing its 
way through the mucous secretions in these tubes, forms bubbles, the 
bursting of which causes the rattle. The crepitant rattle is produced 
by inflammation around the tubercles. The moist, crackling rattle is 
caused by the softening of the tubercles. 

The lungs, rendered more solid by the deposit of tubercles, become 
better conductors of sound ; and this causes the beating of the heart 
to be heard as far ofl" as under the collar bones. 

Bronchial respiration gives the idea of air blown through a tube ; 
cavernous respiration, of air passing into a large enclosed cavity. 

Third Stage. 

Physical Si^ns. — In this stage cavities are formed. If the cavities 
be small, and considerable tuberculated lung surrounds them, the 
sound, upon percussion, is still dull. 

If the cavity be large, and near the surface, there is occasionally a 
tympanitic sound. 

Sometimes a sound is heard like striking a cracked pot. 

Gurgling ; cavernous rattle ; cavernous breathing ; amphoric breath- 
ing ; now and then, metalic tinkling ; pectoriloquy ; cavernous cough. 

General Symptoms. — Great loss of flesh, and weakness; diarrhoea 
and night-sweats ; swelling of the feet and legs ; sore mouth ; and rais- 
ing of matter with specks of tubercle in it like crumbs of cheese. 

Observ^atioiiS. — The gurgling rattle is caused by air displacing 
liquids, and the formation and bursting of bubbles. It resembles the 
sound produced by blowing through a tube immersed in soap-suds. 

Cavernous breathing is nothing more nor less than the sound pro- 
duced by air, breathed in and out, entering and retiring from a cavity. 
The air appears, sometimes, to one listening with the stethoscope, as 
if it were sucked into his ear during inspiration, and blown back 
again during expiration. 

Amphoric respiration is simply an augmentation of cavernous 
breathing, and results, of course, from an increase of size in the 
cavity. 

In pectoriloquy, words uttered by the patient, seem to pass through 
the stethoscope, into the ear of the listener. The cavity should be 
empty, moderate in size, and have dense walls, in order to furnish 
the best specimen of this sound. 

Air suddenly driven backward through the windpipe, and out of the 
mouth and nose, by smart raps upon the chest over a cavity, gives 
the sound of the cracked pot. It is best heard when the patient's 
mouth is partly open. The same sound is produced, on the same 
principle, by locking the fingers of the two hands, and joining the 
palms, so as to leave a small space or cavity between them, and then 
expelling the air from that cavity, by gently striking the back of one 
hand upon the knee. 



DISEASES OF THE CHEST. 215 

Causes of Coiisiiiiiptiou. — The human constitution as shown by 
Liebig, in his profound work on Animal Chemistry, is governed by 
two forces, the nervous and the vegetative. The former disposes the 
particles composing the body to a state of motion ; the latter inclines 
them to a position of rest. 

In vegetative life there is motion in one direction only, so to speak; 
that is, motion which tends to the opposite of motion, namely, rest. 
In vegetables, whose life is wholly under this power, there is no waste ; 
for here, all ultimate particles, having once taken a place of rest, 
remain undisturbed. In a tree, a layer of matter once deposited, 
always remains. Hence there is groiuth as long as the tree lives. 
There is no power to break up and destroy. 

But in the animal body there is motion in two directions, or a 
circuit of motion. Particles which under the vegetative force have 
been put to rest, are perpetually being displaced by the nervous energy, 
and reduced to unorganized amorphous compounds, to be burned in 
warming the system, or cast out by the several excretory processes. 

So constant is the action of these two forces, that John Hunter 
compared the human system to a whirlpool, into Avhich the particles 
of matter are perpetually poured, under the influence of the vegeta- 
tive power, and out of which they are as constantly whirled by the 
nervous force. 

By a little reflection upon these antagonisms, the reader will see 
that it is just when the vegetative force transcends the nervous, that 
the body increases in weight, and acquires that state in which the 
blood corpuscles abound, and the tendency, if to disease at all, is to 
that of the inflammatory kind. It is the tonic condition of the sys- 
tem. Nutrition is more rapid than destruction. New particles are 
laid down faster than old ones are taken up. The body grows. 

On the other hand, when the nervous force overmasters the vegeta- 
tive, when the outward or centrifugal motion of the whirlpool prevails, 
then it is that the body is attenuated, the blood thinned and made 
serous, and the consumptive or atonic condition is established. Now^ 
there is too much motion. The nutritive particles, instead of tending 
to a state of deposit for the re-supply of waste matter, become fugi- 
tive in their habits, perpetually fleeing, like convicts escaped from 
prison. Introduce this power, in excess, into the vegetable kingdom, 
and the matter deposited upon the tree, instead of remaining to swell 
its bulk, would be driven ofl* by the nervous force ; and the tree, in- 
stead of growing, would be annually lessened^ become sickly, and die 
of consumption. 

In Tubercular Consumption, the system is like a field deluged with 
a flood ; nothing can take root. The repeated shocks of the nervous 
battery sent to the absorbents so quicken them in their work of re- 
moving waste matter, that they dislodge much which is not yet worn 
out, and assist in casting out of the system not a little designed to be 
used in its renewal. A healthy deposit is thus prevented, and nutri- 
tion is at an end. The nutritive arteries, those little builders of the 
human frame, are overmastered by the stimulated lymphatics ; the 
constructive material is wrested from them, and borne beyond their 



216 DISEASES OF THE CHEST. 

reach, and the body wastes from want of nourishment. The blood 
becomes thin and watery ; and from the increased serous portion, 
chiefly albumen, are depoited upon the lungs and other tissues the 
albuminous tumors called tubercles. 

Here is found the cause of that peculiar smallness of bone and 
muscle, and thinness and tallness of person, so peculiar to consump- 
tives. The absorbents, under the power of a very active nervous 
system, take down " the house we live in " faster than the nutritive 
arteries, confused by the motion around them, can effect its recon- 
struction. It is simply an unbalancing of the antagonistic forces, 
which build and pull down our earthly tenement. The men that de- 
molish are more numerous and better fed than the artisan builders. 

It is this destructively nervous force which gives to consumptive 
persons their proverbial mental activity ; which causes them often to 
dazzle the world with the splendor of their gifts, and to bless their 
friends with the warmth of their affections. They are usually the 
choice spirits^ the idols of their rela.tives, and the favorites of the com- 
munity in which they live. Their mental movements, and the exer- 
cise of their affections, are characterized by brilliancy and warmth. 
Of all persons, they are best fitted to enjoy life, and to impart happi- 
ness. Loving all, they are by all loved in return. They are speci- 
mens of partially etherealized humanity, stepping lightly across the 
earth, to whom friends passionately stretch out their arms, and em- 
brace — their shadows ! 

These views will appear the more reasonable, if we consider that 
in children the vegetative power is very active, while the nervous 
energy is comparatively weak. The preponderance of the former 
over the latter causes the rapid growth of children. The little arterial 
builders work faster than the lymphatic demolishers. This explains 
why so few children die of consumption. 

But from the age of seventeen to thirty-live, when the vegetative 
power is losing something of its extraordinary activity, and the nerv- 
ous force is showing its highest capabilities, — then it is, as this 
theory indicates, that tubercular consumption does its dreadful work, 
— then, that the outward whirl of this physiological Maelstrom casts 
upon the shores of mortality so many thinned, exhausted, and lifeless 
human forms. More than three fourths of all who sink under this 
disorder die between the ages just named. The brain, between these 
points of time, acquires its full size and force. 

This disease prevails most, too, in those countries where an enlight- 
ened civilization gives to the nervous system its fullest development, 
as in Great Britain, France, and the United States, and in those 
where the nutritive process is most retarded by a relaxing climate ; 
and it is carcely known among those people who are but little en- 
lightened and have small brains, and among those who live in high 
and invigorating latitudes. As the most enlightened, however, are 
generally found in temperate climates, and those with the least culti- 
vated brains in low latitudes, the rule is not perfectly explained by 
facts ; yet it shows itself sufficiently to establish its validity, and to 
afford another proof of my theory. 



DISEASES OF THE CHEST. 217 



Bronchial Consumption. 

The persons exposed to bronchial consumption are generally of an 
opposite habit to those described above, — having the nervous force, 
in health, well subordinated to the vegetative, the assimilation good, 
and the blood well supplied with red globules. They have usually a 
full habit and an active circulation. The absorbents, and other ves- 
sels in the lungs, working in the midst of a large amount of caloric 
i evolved by an energetic respiration, often take cold, which brings on 
! lung fever and pleurisy, and these lay the foundation for the ultimate 
destruction of the lungs. For the same reason, the skin of this class 
of persons becomes diseased, and more often the inner skin, or mu- 
cous membrane, and most often that portion of mucous membrane 
which goes down into the lungs and lines the air tubes. It is inflam- 
mation of this which constitutes bronchitis, and which lays the foun- 
dation for true bronchial consumption. 

As that class of persons who are exposed to the tubercular form of 
the disease suffer a general loss of carburetted hydrogen in its several 
forms, colliquative diarrhoea, sweats, increased breathing, and all con- 
ditions that carry fat out of the system, so those who suffer from 
attacks of the bronchial type of the disorder are generally afflicted 
with the opposite condition. They have too much carbon. 

It is well ascertained that carburetted hydrogen, accumulated in 
the system, acts as a poison. And that class of bilious persons who 
are subject to this disease often have their excretions badly performed. 
For this reason, carbonaceous compounds accumulate in the system, 
and give rise to the symptoms of morbid poison circulating in the 
blood. This led Dr. Gladden to suspect the presence of such poison 
in the blood of all consumptive persons. He saw the evidence of it 
in numerous cases, and not distinguishing the one class from the 
other, he inferred its presence in all. 

Constitutional Difference. 

The constitutional difference between the two forms of consump- 
tion appears to be this : the tubercular type is usually attended, in its 
origin, by a tolerably good state of the digestive function, in connec- 
tion with bad assimilation ; while the bronchial form generally has 
its foundation laid in connection with bad digestion, accompanied 
with healthful assimilation. In the former case, the food is well di- 
gested, the pabulum is properly prepared, but the nutritive arteries do 
not use it for renewing the tissues. In the latter case, the digestion 
is bad, the pabulum poorly elaborated ; but the re-constructive vessels, 
under the control of a well-developed system of organic nerves, use 
it to the best advantage. In the one case there are good hxiok-makers^ 
and lazy hYick-layers ; in the other, the reverse. 

It happens, however, that before the fatal close of the disease, tu- 
bercular patients usually become afflicted, more or less, with bad 
digestion, and bronchial patients with defective assimilation ; so that, 

28 



218 DISEASES OF THE CHEST. 

in the end, they present us with much the same class of symptoms. 
Starting from opposite poles in life's celestial sphere, they meet at 
the culminating point of death, and disappear under identical aspects 
of the heavens. 

Exciting Causes of Tubercular Consumption. 

The preponderance of the nervous force being the state which pre- 
disposes to disease, whatever unduly excites the nervous energy in- 
vites an attack. 

These causes relate, mostly, to the p?'olonged exercise of the intellect, 
the passions, and the sentiments. 

Few are aware of the mischief done by excessive stimulation of 
the mind during the most active period of life, — especially if the 
muscular system be left half developed. Here is where ambitious 
students commit great errors. 

The constant plying of the mental powers, in the present modes of 
educating children, leads to a dreadful abridgment of human life. 
Better to train the bodily powers first, and let the rnental culture 
come in later time. He who would build a lasting structure must 
lay a solid foundation. 

The age in which we live abounds in the causes of excitement. The 
world is trembling with excess of mental life. The pine trees burned 
by the steam engine are scarcely more numerous than the human 
constitutions consumed by the train of thought it has set on fire. 

Nor are the passions and sentiments less exercised, or less destruc- 
tive. 

Briefly, the causes of consumption embrace all those things which 
bring a destructive force against the digestive and assimilative func- 
tions, as insufficient and improper food, debaucheries, night-watches, 
sedentary habits, anxiety of mind, etc.; and those which act injuri- 
ously upon the breathing organs, as impure air, inflammation of the 
lungs, pleurisy, measles, hooping cough, etc. ; and such as disturb the 
sweating process, as insufficient clothing, sudden changes of temper- 
ature, sleeping in damp sheets, etc. These exalt the nervous force, 
or depress the vegetative, or inflame the mucous lining of the air 
tubes, or the substance of the lungs, or the membranous sack which 
encloses them, so as to induce one form or other of consumption on 
the principles I have explained. 

Can Consumption be Cured ? — In many cases it can. It may be 
cured, first, by the absorption of the tubercles. The celebrated John 
Hunter shows, in his work on the blood, that the absorbent vessels 
have a sort of elective affinity, by which they take up and remove " all 
adventitious new matter, as tumors," (tubercles are albuminous tu- 
mors,) more easily "than those parts which were originally formed." 
Were this not so, an activity in these vessels equal to the removal of 
tubercles, would cause them to waste all the tissues, and aggravate 
rather than cure consumption. Probably this does occur where 
proper hygienic means are not used to quicken the excretions. This 



DISEASES OF THE CHEST. 219 

hygienic treatment, to be spoken of hereafter, is not generally em- 
ployed, — certainly not as etfectually as it should be. Here is the 
source of Laennec's fatal remark, so often quoted and so widely en- 
dorsed, that " nature's eflbrts towards effecting a cure are injurious, 
and those of art are useless.'' Laennec's position cannot be true, if 
Hunter's statement is correct. If the absorbents, by an elective in- 
stinct, take up adventitious matter rather than the natural tissues, 
then the reason why they reverse this rule^in consumption is, that by 
a weakened state of the constitution, the ultimate particles are not 
well put together, and arc more easily taken apart than those of the 
adventitious tubercular tumors ; and if we would restore these vessels 
to their natural activity, we must improve assimilation, and knit the 
unloving molecules into a firmer brotherhood. We must make the 
flesh hard, so that the absorbents cannot pick it to pieces. Do this, 
and "nature's efforts to effect a cure," will not "be injurious." 

A second form of ci^re is the reestablishment of the assimilative 
function, the building up of the general health, the arresting of the 
tubercular deposit, the reducing of tubercles already formed to an in- 
dolent state ; and then, by a strict observance of the laws of health, 
keeping them in that condition through life. 

A third mode of cure is the healing of the cavities after the tuber- 
cles have softened, broken down, and been expelled in the form of 
expectoration. 

A fourth method of cure is a change of tubercles to calcareous mat- 
ter. These calcareous tubercles, Laennec says, "are consequent to 
tuberculous affections that have been curedJ^ And Andral, at one 
time, hoped to learn how to effect cures by changing tubercles to " the 
calcareous phosphate." 

I have had several cases of cure by this last method, and have 
quite a collection of calcareous substances which my patients have 
coughed up, — one of which was raised in my presence by a lady 
who was a few years before in hopeless consumption, but is now in 
good health. 

Treatment, — This should be of two kinds, local and general. 

The local treatment of consumption is by the inhalation of vapors 
and powders into the lungs. It has been practised, more or less, by in- 
dividuals, for many years, particularly in Europe ; but for some unac- 
countable reason, the profession generally have never used it, and do 
not know much about it. I had the honor, some years ago, to bring 
it freshly before the American public, in some articles written for 
popular reading, since which time it has been rapidly gaining public 
confidence, and is now attracting much attention. Conveying the 
remedy directly to the diseased parts, it strikes the common-sense 
mind as eminently reasonable and necessary. 

I shall speak of inhalation, therefore, very earnestly, not as a pallia- 
tive of consumption only, but as far more, as a remedy. After long 
and patient use, my experience allows me to say, that I know it, in 
many cases, to be such ; and knowing this, I should be criminal not 
to press it upon the public ; for it is the great multitude of sufferers, 



220 DISEASES OF THE CHEST. 

pressing fast through the gate of death, who need to hear words of 
hope. 

Consimiptioii a General Disease. — It is not denied that consump- 
tion is a general disease, needing constitutional treatment ; but it has 
also a local development in the lungs, first in the form of albuminous 
tumors, called tubercles, and then, after the softening, breaking down, 
and discharge of these, in the more formidable shape of ulcerous cav- 
ities, which, beginning at the summit, devour the lungs down to the 
base. Can it be reasonable to apply no remedy directly to this local 
disease ? Not so does our profession deal with other local diseases. 
To an inflamed skin we apply poultices, cold compresses, solu- 
tions of acetate of lead, nitrate of silver, etc. ; to leprous or scaly 
affections, sulphuret of potash, bichloride of mercury, zinc ointment, 
nitrate of mercury ointment, sulphur, creosote, etc. ; to weak and 
inflamed eyes, sulphate of copper, sulphate of zinc, nitrate of silver, 
and opium ; to chronic ulcers upon the skin, tannin, pulverized 
rhubarb, opium, or cinchona ; and to an inflamed throat, nitrate of 
silver and other articles. These are but specimens of the thousand 
cases in which we use local remedies. Why, then, when the mucous 
membrane, which lines the air tubes, becomes inflamed through all its 
branches, should we neglect, by the inhalation of medicated vapor, to 
apply a remedy directly upon the whole inflamed surface ? Why, 
when tubercular matter is beginning to be deposited upon the surface 
of the air cells, and of the small bronchial tubes, should not the vapor 
go right to those parts, and cause, as it would, the immediate expul- 
sion of tliis oftending and dangerous matter ? 

Uneducated common sense sees the reasonableness of these sug- 
gestions at a glance. Many a person, with pulmonary disease, dies 
of suffocation, not because there is not muscular strength to expel 
the matter which is strangling him, but because the lungs beloiv the 
large pellets of mucus, which plug up the bronchial tubes, cannot be 
inflated, and have therefore no means of driving out the offending 
substance. Yet a proper medicated vapor, drawn in with the breath, 
would either dissolve the mucus, or rouse up the expiring membrane 
to cast it off. 

If the reader were to place one end of a stethoscope directly over 
the disease upon the breast of a person in the third stage of consump- 
tion, and should then ask him to talk, the words spoken would seem 
to rise up through the instrument, and enter, well articulated, into his 
ear. This, in technical language, is called pectoriloquy^ — a word 
signifying chest-talking. It implies a cavity in the lung. If now the 
patient be asked to cough, a gurgling and splashing sound will be 
heard. This denotes that the cavity is partly filled with fluid, which 
is dashed about by the air explosively driven through it by the portion 
of lung below. Here we have an excavated ulcer, with all its filthy 
contents, composed of pus, mucus, serum, and dissolved tubercles, 
lying in it day and night to aggravate its unhealthy condition. What 
more reasonable, what more necessary, than that a soothing, altera- 
tive, or astringent vapor should be draw^n into this cavity, to cause its 



DISExVSES OF THE CHEST. 221 

sides to heal, and its absorbents to remove this fluid ? A surgeon 
who should permit an ulcer upon the surface of the body to remain 
in that condition without a local dressing, would be deemed unfit to 
practise his profession. 

Both in tubercular disease and in simple bronchitis, the bronchial 
tubes almost aways suffer some physical change. The mucous mem- 
brane lining these tubes is generally softened. At other times the 
tubes become enlarged through their w^hole length, so that many of 
them, from the size of a quill, reach the bigness of the finger of a glove. 
In still other cases, the straining produced by coughing causes a tube 
to belly out at some point, forming a sack, which is generally filled 
with mucus or purulent matter. At still other times, a tubercle will 
press against a tube so as to flatten it and convert it into a musical 
instrument, the air, as it is drawn laboriously through, producing a 
high or low note, according to the size of the pipe. These physical 
changes are all produced by causes which the inhalation of a suitable 
vapor, at the proper time, would almost infallibly remove. How 
strange that this remedy, — so simple, so effectual, so easily compre- 
hended, — should have been so little used ! 

Right at this vital point in the lungs, where the blood runs in a 
ceaseless current, — where the whole of it goes every tioo minutes to 
renew its vitality by contact with atmospheric air, — we have, in 
thousands of cases daily occurring, inflammation with roughening or 
softening of membrane, with its consequent harsh breathing; we have 
mucus, tough origlairy, to impede and interrupt respiration ; we have 
tubercles in the hard or soft state, adding to the general embarrass- 
ment, and not only lessening the vitality of the blood, but disturbing 
all the sympathies of the system; — and yet the practice has been, 
and is, to attack these central disturbers of life only through the cir- 
cuitous path of the stomach, lacteals, etc. 

Since 1849, my undivided attention has been given to the study 
and application of this mode of treatment. This is two years in 
advance of any other physician in this country. I have investigated 
faithfully the effects of the various substances proposed for inhalation 
by European physicians, and have explored a wide field of new rem- 
edies, not before used, several of which have proved to have qualities 
of gi'eat remedial power. 

Thus much I have thought it proper to say in behalf of this mode 
of treating consumption, the most successful yet employed, not be- 
cause it needs defence, but because the great body of the profession 
are ignorant of it, and what is worse, are indifferent. 

The chief remedies I employ for inhalation are the following : 

Alterative Inhalant, composed of iodine, six grains ; iodide of potas- 
sium, twelve grains ; tincture of ipecac, one ounce ; tincture of bal- 
sam of tolu, six drams ; ethereal tincture of conium, one and a half 
drams ; alcohol, half a pint. These are to be mixed. The dose is 
one to two teaspoonfuls, to be inhaled ten or fifteen minutes, in about 
a gill of hot water. 

The ethereal tincture of conium is made by keeping a dram of 
powdered conium in one ounce of s'ulphuric ether a week. 



222 DISEASES OF THE CHEST. 



The above inhalant is used in the tubercular forms of consumption, 
particularly that of the scrofulous kind, and in many cases of bron- 
chitis. 

Expectorant Inhalant. — Take pleurisy root, half an ounce ; squill, 
one ounce ; ipecac, two drams ; black cohosh, two ounces ; queen's 
root, one ounce and a half ; American hellebore, two drams ; diluted 
alcohol, one pint. Grind the roots, etc., and add the alcohol. Let the 
whole stand one week, shaking or stirring daily. Draw off and filter 
through paper. Two teaspoonfuls make a dose, to be inhaled same 
as preceding. 

This is to be used when the cough is hard and dry, and the expec- 
toration difficult. It makes the raising easy, lessening the soreness 
of the chest, and the harshness of the cough. 

Soothing, Febrifuo'e Inhalant. — Take belladonna leaves, half an 
ounce ; black cohosh, two ounces ; American hellebore, half an ounce ; 
poke root, two drams ; aconite root, one ounce ; diluted alcohol, one 
pint. Grind the roots, etc. ; add the alcohol. Let the whole stand 
one week, stirring daily. Pour off, and filter through paper. Dose, 
one to two teaspoonfuls, to be inhaled as the preceding. 

This is excellent in all cases where the skin is hot, the pulse quick, 
the tongue and mouth parched, the chest sore, and the system suffer- 
ing during the whole or a part of each day, from a general feverish 
condition. It is proper in all the forms of chest disease. 

Astringent Inhalant. — Take of wild indigo, one ounce ; catechu, 
half an ounce ; Peruvian bark, one ounce ; golden seal, one ounce ; 
diluted alcohol, one pint. Mix, and let the whole stand one week, 
stirring daily. Drain off, and filter through paper. Add two drams 
of creosote. One to two teaspoonfuls to be inhaled as preceding. 

This is to be used when the expectoration is profuse and easy, un- 
attended by fever, either in the latter stages of chronic bronchitis, 
when the mucous membrane of the tubes is in a relaxed condition, 
or, in the third stage of tubercular disease, for the purpose of con- 
stringing, cleansing, strengthening, and healing. 

Antiseptic Inhalant. — Take wild indigo, one ounce ; belladonna 
leaves, half an ounce ; diluted alcohol, one pint. Mix, and let the 
whole stand one week. Pour off, and filter through paper. Then 
add solution of chloride of soda two ounces. Dose, one to two tea- 
spoonfuls, to be inhaled as the preceding. 

This is used in cases of gangrene o5 the lungs, generally distin- 
guished by considerable expectoration having a very fetid smell. 

Anti-Hemorrhao'ic Inhalant. — Take w4tch-hazel bark, two ounces ; 
black cohosh, four ounces. Grind, and add one pint of diluted alco- 
hol. Let the mixture stand one week, stirring daily. Pour ofl', and 
filter through paper. Add to this two drams of creosote. Dose, one 
to three teaspoonfuls, to be inhaled as preceding. 

This is an excellent remedy for bleeding from the lungs. When 
there is a tendency to bleed, it should be used for a long time. It 
may frequently take the place of No. 4, as an astringent inhalant. 



DISEASES OF THE CHEST. 



223 



Object of luhaliUlts. — Being vaporized and inhaled, these articles 
enter every air cell throughout the lungs. Their object is to soothe and 
mollify inflamed mucous surfaces, to reduce enlarged bronchial glands 
Avhich press upon neighboring parts and cause bleeding, to stimulate 
the absorbents to take up and remove tubercles, to dissolve tubercles 
out of the pulmonary tissue, to cause ulcerous cavities to expel their 
mattery contents, and to stimulate their sides to take on a healing 
process. They should be used from three to six times a day, the in- 
iialation continuing from ten to fifteen minutes. 

Other Iiilialailts. — Great numbers of other articles have been used, 
which I have not space to describe. I will mention, however, that 
the following are sometimes employed with advantage : 

For an Expectorant Inhalant, take alcohol, four ounces ; tincture 
of camphor, half an ounce ; tincture of tolu, two drams ; naphtha, 
one dram ; benzoic acid, thirty grains ; oil of bitter almonds, four 
drops. Mix. 

For an Anodyne Inhalant, take alcohol, four ounces ; naphtha, one 
dram ; benzoic acid, thirty grains ; chloroform, twenty-five drops ; 
tincture of henbane, half an ounce. Mix. 

For an Astringent Inhalant, take alcohol, four ounces ; naphtha, 
one dram ; benzoic acid, thirty grains ; chloroform, one dram ; tannin, 
eight grains. Mix. 

Mode of Iiihaliii«\ — For inhaling these, a sponge is fitted into a 
glass cup, to which a flexible tube is attached. A small quantity of 
the mixture is poured upon the sponge, and the vapor arising, is 
drawn into the lungs through the tube. 

To the expectorant inhalant may be added, occasionally, half a 
dram of nitric acid. 

These latter formulas are the principal ones used by those who 
practise what is called cold inhalation. 

Meclicated-Yapor Inhaler, — This instrument I have had constructed 
of britannia (sometimes of silver) and glass. Some 
have adopted the mode of inhaling from a sponge 
held in the hand, which is an imperfect method ; 
others, that of inhaling from a sponge fastened 
upon the chest, which amounts to scarcely any in- 
halation at all, as only a very small amount of the 
vapor reaches the nostrils. It is, moreover, disa- 
greeable to the wearer and to those around, and 
must soon become extremely filthy. 

Some use a glass bottle, with an India-rubber 
tube ; but India-rubber soon becomes foul inter- 
nally, and might produce disease. Avoid Inhalers 
with India-rubber tubes. 

The cut 91 represents the instrument I employ. 
The tube, to which the mouth is applied, passes 
through the cap, communicating with the air 
above the fluid. When the air is drawn off', other air rushes into the 
long tube to fill the vacuum, and breaking out at the bottom, sets 



Fm. 91. 




224 DISEASES OF THE CHEST. 

the fluid in commotion, causing a medicated vapor to rise, which is 
drawn into the lungs. 

Constitutional Treatment, — The rapid breathing in consumption, 
creates too much oxydation of the blood, — so much, that the muscles, 
especially the heart, are usually of a bright red. To prevent the pa- 
tient from being literally burned up by oxygen, the blood must be 
de-oxydated as fast as possible. 

While there is too much of oxygen, there is, at the same time, a defi- 
ciency of carbon. Hence the cold hands and feet, and the general 
inability to bear frosty weather. The little nutritive arteries, in these 
thin-blooded persons, stand shivering and torpid with cold, unable to 
perform their allotted function of nutrition. There is not fire enough, 
and fuel must be had in the form of carbon. . Hence one of the ad- 
vantages of cod liver oil. This oil, too, as carbon, devours the oxy- 
gen of the blood, and prevents its destroying the patient. This idea 
also explains the fact mentioned by Bennet and others, that in their 
post-mortems, they found the evidences of healed ulcers in numerous 
persons who had been spirit-drinkers w^hile living. And Liebig helps 
the explanation by saying that alcohol, taken into the system, circulates 
in a free state in the blood, and devours its oxygen. To which I beg 
to add, that the malaria of intermittent and bilious fever districts, has 
been pretty satisfactorily proved to be an instable organic body, con- 
sisting of sulphur, carbon, and hydrogen, all of which have an af- 
finity for oxygen, and devour it in the system. Consmnption is not 
found in such districts. 

As I am here treating of the chemical effects of remedies (and to 
this test, most remedies must finally come), I will mention that tar- 
trate of antimony and potassa arrests the circulation in the pulmonary 
arteries^ — which fact gives a complete and luminous view of its 
power to prevent oxydation. But I am obliged to detract from its 
merits, by stating that it also retards the circulation in the capillaries 
of the system generally, and so hinders <ie-oxydation. 

Phosphorus. — There is an article which has more recently pre- 
sented itself to the notice of the profession, to which I wash to invite 
special attention. I refer to phosphorus. This agent, for a time, 
challenged our notice in the shape of phosphate of lime ; but we could 
never feel sure that this article was dissolved in the fluids of the body. 
We now use, and with far more marked efTect, the hypo-phosphites 
of lime, soda, potash, and iron. These are used in the form of the 
syrup of the hypo-phosphites. The dose is a teaspoonful before 
each meal. The effect upon the tubercular disease is immediate and 
gratifying. 

IVeed of Phosphorus. — Cerebric acid contains nitrogen and phos- 
phorus, and is the peculiar component of the brain and nervous sys- 
tem. By combustion and the changes of oxydation in the brain, the 
phosphorus of cerebric acid is converted into phosphoric acid; so that 
every act of the brain produces phosphoric acid. How rapid, then, 
must be the consumption of the phosphoric element of the cerebric 



DISEASES OF THE CHEST. 



225 



acid, in that highly active and excitable state of the nervous system 
which I have described as peculiar to consumption. And how neces- 
sary in order to save the brain from destruction, to meet this increased 
demand for phosphorus, by introducing it into the system. 

JNIulder regards the fibrin of the blood as the carrier of oxygen ; and 
by this oxydation, the fibrin becomes converted into the binoxide and 
tritoxide of proteine, — its phosphorus and sulphur (for it contains 
both), being converted into phosphoric and sulphuric acids. Adding 
phosphorus and sulphur, therefore, as medicinal agents, would seem 
to be the proper way to supply the fibrin with materials destructive 
of its freight of oxygen. 

It is well known that the salts of phosphoric acid are essential for 
the formation of azotic compounds, — compounds which are neces- 
sary to sustain animal life. It should be remembered, too, as collat- 
erally illustrating this fact, that the tribasic phosphates of potash, soda, 
lime, and magnesia, play an important part in the growth and perfec- 
tion of plants. They are always found in the seeds of the cerealia, and 
no matvire grains are produced where phosphates are absent from the 
soil. For the production of abundant grain crops, it is necessary that 
these salts should exist in the soil, or be applied to it in nlanures. 

It is known, moreover, that in all chronic diseases distinguished by 
wasting of the tissues, a much larger quantity of phosphates is ex- 
creted by the kidneys, than in the normal state. Hence there is no 
healthful growth ; and the human organism, like the soil, exhausted 
of its phosphates by successive croppings, brings nothing to perfec- 
tion, and needs to have its drained salts re-supplied. 

I cannot but call attention here to the inorganic substances found 
in healthy human blood. According to very careful analyses, by 
Scmidt : 



1000 parts of blood-corpuscles, contain : 

Chlorine, 1.686 

Sulphuric Acid, - - - 0.066 

Phosphoric Acid, - - - - 1.134 

Potassium, - - - - 3.328 

Sodium, 1.052 

Oxygen, 0.667 

Phosphate of Lime, - - - 0.114 

Phosphate of Magnesia, - - 0.073 



1000 parts of liquor sanguinis (serum and 
fibrin), contain : . 

Chlorine, 3.664 

Sulphuric Acid, 
Phosphoric Acid, - - - 
Potassium, - - - 

Sodium, > - _ - 
Oxygen, - - - - 
Phosphate of Lime, 
Phosphate of Magnesia, - 



0.115 
0.191 
0.323 
3.341 
0.403 
0.311 
0.222 



Iron is omitted. Now, I venture the prediction, that out of these 
figures, mainly, in connection with those which represent the constit- 
uents of the saliva, the bile, the gastric juice, the pancreatic secretion, 
and the organic compminds of the blood and tissues, are to be evolved 
within a few years, a correct and partially demonstrative system of 
medication. In consumption, all the inorganic bodies represented by 
the above figures, with the exception of oxygen, are deficient in quan- 
tity. By reflecting upon the proportions of these several bodies, par- 
ticularly upon the large amount of chlorine and soda in the plasma, 
and of potassium in the corpuscles, the mind can hardly fail to obtain 
useful hints. I have not hesitated to make one of these hints the 

29 



226 . DISEASES OF THE CHEST. 



ground of a very free u^e of alkalies, — particularly in the form of 
bathing. 

Su^ar of Milk. — There is one other medicinal article which I deem 
worthy to be made prominent, and to be placed side by side with cod 
liver oil and the hypo-phosphites. I refer to sugar of milk. It belongs 
to that class of non-nitrogenized articles Which Liebig has denominated 
supporters of respiration. Its great affinity for oxygen is well worthy 
to be taken into the account, in considering its value in consumption. 
So great is this attraction, that with ammonia and other alkalies, it 
has the power of reducing some of the metalic oxides. When taken 
into the stomach, it is rapidly absorbed into the blood, which, being 
an alkaline fluid, augments its great de-oxydating power to a consider- 
able degree. It unites rapidly with oxygen after entering the blood, 
forming carbonic acid and water. A part of it, however, does not 
enler the blood in an uncompounded state, but is changed in the 
stomach into lactic acid; and this, in the blood, becomes an alkaline 
lactate. But the portion thus changed, appears also very useful ; for 
Lehmann says : " We know of no substances which could better act 
in the blood as food for the respiration, than the alkaline lactates." 

Corroborative of these views, is the fact that all those kinds of 
milk, such as goat's, ass's, etc., which contain the largest amount of 
sugar of milk, have at different times, and in various countries, ob- 
tained a reputation for curing consumption. Goat's whey, in which 
this article abounds, and from which it is largely manufactured, has 
been celebrated for its virtues in this line. Ancel speaks of it as an 
excellent remedy ; and Pereira says, " Sugar of milk, in consumptive 
cases and chronic diseases of the digestive organs, is a most valuable 
-aliment." 

One of the best forms of taking sugar of milk is that of a gruel, 
which is quite palatable, and may be freely eaten by consumptive 
persons. 

The Coug'h. — The best article I have ever used for this, is the "Pul- 
monic Cherry Cordial." I was five years in compounding this arti- 
cle to suit me, and I believe it to be the very best cough preparation 
ever made. Dose, from one to two teaspoonfuls. 

When a more quieting effect is needed, a little morphine may be 
added to this preparation ; if a more expectorant influence is required, 
add a few drops of the tincture of veratrum viride. For the great 
majority of cases, it will be found to be right without any addition. 
When this is not at hand, any of the preparations (108) (112) (109) 
(113) (110), etc., may be used. 

Night Sweats. — The very best preparation for these sweats, is a com- 
pound of the oxide of zinc, one dram ; extract of conium, half a dram ; 
to be made into twenty pills, of which one or two are to be taken 
every night. The sponge bath also does much to check these sweats. 

Diarrhoea. — This is a most exhausting symptom in the latter stages 
of consumption. The only remedy which has much effect in control- 
ling it, is the tris-nitrate of bismuth. This should be given in doses of 



DISEASES OF THE CHEST. 227 

thirty grains immediately after, or at the time of each meal. These 
doses are much larger than used to be given ; but they will do no 
harm. Given to this extent, I find the bismuth very effectual. 

Iron. — This preparation, in some of its forms (316) (73) (61) (84) 
(102), is almost always needed in consumption. If the scrofulous 
habit be strongly marked, give syrup of iodide of iron, in thirty-drop 
doses, three times a day. It should be taken in a glass of water. 

Evteriial Irritants. — These are needed where there is much inflam- 
mation and soreness of the chest. Blisters should very seldom be 
used. Croton oil, from two to half a dozen drops, rubbed over the 
sore part, generally answers very well. Sometimes the mustard paste, 
applied to the extent of producing redness, two or three times a week 
is sufficient. Nitric acid, reduced with water to a strength a little 
above the strongest vinegar, answers a good purpose for keeping up 
an irritation. 

Atniosplierkj Inhalation. — It has been said by Laennec and others, 
that asthma has sometimes the effect of arresting tubercular con- 
sumption. Dr. Ramadge thought this was effected by an expansion 
of the vesicular structure of the lungs ; and he reasoned that the 
same expansion by mechanical means, would secure a similar end. 
To effect this, he made his patients take long breaths through a tube 
constructed for the purpose. 

It is manifest that the philosophy of atmospheric inhalation was 
not understood by Dr. Ramadge, nor has it been by any of his fol- 
lowers in this country. 

Rokitansky thinks the tubercular habit depends upon the excess of 
fibrin in the blood ; and says that the reason of consumption being 
arrested by pregnancy is, that this condition offers a mechanical ob- 
stacle to the transmission of blood through the lungs, — thus prevent- 
ing its excessive oxydation, and keeping it in a venous state. This 
destroys the fibrinous condition, on which he thinks tuberculosis 
depends. 

Now this is precisely what is done by atmospheric inhalation.. The 
trachea divides on its entrance into the lungs, into two branches, which 
again divide and subdivide until the tubes become smaller than can 
be seen, each terminating in a minute air-cell. Over this entire sur- 
face the air is intended to be brous^ht into communication with the 
blood for the purpose of oxydating it. By forcible inhalation, the air 
vesicles are inflated to the extent of their capacity, by wiiich means 
the extreme branches of the pulmonary arteries are so flattened be- 
tween these extended cells, as to be able to convey but a small 
amount of blood, and but little is oxydated. This furnishes a me- 
chanical obstruction to the transmission of the blood, and secures tha 
defibrination of which Rokitansky speaks. 

This is my view of the philosphy of atmospheric inhalation. The 
benefit results, not from a larger amount of oxydation, as is gener- 
ally supposed, but from a smaller. Asthma does the same thing by 
producing spasmodic contraction of the extreme bronchial tubes, and 
preventing air from entering the cells. 



228 DISEASES OF THE CHEST. 

The same end is gained in part by certain kinds of employment, as 
glass-blowing, playing upon wind instruments, and the like. Writers 
of distinction mention cases of recovery from incipient consumption 
by a vigorous use of the lungs in singing. Dentists subject their 
lungs to a similar process of expansion in the use of the blow-pipe ; 
the writer has known several instances in that profession, in which 
recoveries have taken place. 

The Conclusion to which I come is, that atmospheric inhalation 
may be used with great advantage in some cases, but should never be 
resorted to except under the direction of a competent physician. In 
a congested state of the lungs, with haemorrhagic tendencies, or with 
inflammation and soreness, it is well fitted to produce fatal bleeding, 
and is of course dangerous. 

External Tse of Water. — As a relaxation from severe exertions, 
the ancients had frequent recourse to bathing. Those who contended 
in the race, throwing the javelin, and wrestling, at Rome, plunged 
into the Tiber while warm and panting with their efforts. That this 
promoted prowess and physical endurance, none can doubt. 

Louis, the great French authority on pulmonary diseases, lays 
down several rules to be observed by consumptive patients, and par- 
ticularly mentions cold bathing. 

Few^ things give tone to the capillaries of the skin like cold water, 
systematically applied. It rallies the powers of the constitution, and 
improves assimilation. And by it another object is gained of scarcely 
less importance, — that of guarding the system against taking cold. 
Those in the daily habit of applying cold water to the whole person, 
seldom suffer from colds and catarrhs ; and they generally become 
hardened so as to endure the assaults of the elements. 

Consumptive persons should generally use the sponge bath, with 
cold water, if it can be endured, otherwise the tepid bath, to be fol- 
lowed, in all cases with brisk rubbing, with a coarse towel. If a sense 
of chilliness and discomfort follows the bath, a large portion of the 
water must be squeezed from the sponge, so as to use but very little, 
and the washing must be speedy, and the rubbing more lively than 
usual, — beginning with tepid water, and gradually lowering the tem- 
perature, till it can be borne cold. A large teaspoonful of saleratus 
to each quart of water should be used. 

Diet. 

The diet, like all other parts of the treatment, must have reference 
to the present condition of the patient. If the disease take the bron- 
chial form, and rapid breathing, and other conditions calculated to 
carry fat out of the system have not yet supervented ; or if the patient 
have thirst and hectic, the diet must be spare and simple, — consist- 
ing chiefly of milk and farinaceous substances. 

But in all cases where the disease is tubercular, or, being bronchial, 
has reached the stage of emaciation, the very earliest moment at 
which the fever can be subdued, should be improved to build up the 



DISEASES OF THE CHEST. 229 

patient with a generous diet. I have seen cases where the stuffing 
sometimes resorted to for fattening turkies for Thanksgiving, would 
seem to be ahnost justifiable. A good rule is to give the most gener- 
ous diet that can be taken without disturbing the stomach, or increas- 
ing the feverish symptoms. Animal food, with a good quantity of 
salt, should be freely taken. Fat meats, if well received by the stom- 
ach (and they generally are if taken cold)^ are particularly useful. 
The same is true of sweet butter and cream. 

Out-Door Exercise. — Without exercise, as a general thing, the con- 
sumptive patient will die. Exercise involves muscular exertion, 
which is attended by the tension, compression, and greater compact- 
ness of the muscles used. This compression of the muscles within 
the sheaths (fascia) which enclose them, sends out their blood, and 
pushes it forward towards the surface. Reaching the extremities of 
the arteries, the blood passes through capillary tubes, almost incon- 
ceivably fine, into the capillary veins of similar fineness, whence it 
flows through larger and larger veins back to the heart. At the mo- 
ment of its passage from the capillary arteries to the capillary veins, 
it ceases to be red or arterial, and becomes purple or venous blood. 
The oxygen in the arterial and the carbon in the venous blood unite, 
forming a literal combustion, just such as we produce in our stoves 
and grates by bringing together the carbon of the wood and the oxy- 
gen of the atmosphere. By this combustion our bodies are warmed, 
and the little secreting, exhalant, and other vessels, are raised to a 
temperature that enables them to work. 

Every muscular contraction and compression helps push along the 
venous blood in larger quantities to the right auricle of the heart, 
which, receiving a fuller supply of its natural stimulus, contracts more 
energetically, forcing the fluid into the right ventricle. From thence 
it is expelled with increased energy likewise along its only pathway, 
the pulmonary artery, into the lungs. Rushing in here in greater 
volume than natural, a demand is made for deeper inspirations of 
air to vitalize and fit it for its descent by the pulmonary vein, to the 
left auricle. Coming here also as the natural stimulus, in larger 
quantities than usual, it gives increased energy to its own propulsion 
into the left ventricle, from whence it is driven out through the arte- 
ries to all parts of the system, by the powerful strokes of that strong 
muscle. 

Thus it goes its round, urged on by exercise, parting with its oxy- 
gen more and more freely in the capillaries, giving more activity to 
the vessels of the skin and other tissues, increasing the depth and 
strength of breathing by carrying more venous blood to the lungs ; 
improving the digestion, carrying a better elaborated pabulum to the 
nutrient arteries, and causing them to work it up more diligently in 
renewing the tissues. 

Nor is this all. Every wrench of a muscle forces some old, worn 
out particles from their places, allowing none to remain except such 
as are firm, and able to bear the brunt of exertion. The flesh of those 
who exercise much becomes hard and enduring. 



230 DISEASES OF THE CHEST. 

I say then to the consumptive, if you would live and not die, 
exercise, exercise^ exercise. It is the first, second, and third thing. 
If you ask for the modes of exercise, I say take it on foot, out of 
door, every day, to the extent of a small amount of fatigue. Don't 
be frightened by a single cloud, or even by a cohort of them. You 
have as good a right to be out as the clouds ; and they will not look 
more angry, but rather more agreeable from finding you abroad in 
their company. The elements of nature are at war with organic life. 
Against them the vital principle has to maintain a perpetual struggle ; 
and he who loses the power to meet and gain the victory over them 
by out-door exercise, is beginning to die. 

Go abroad, therefore, often. Try it again and again. Extend 
your walk a little every day. Stretch it out to the distant fields. 
Gather flowers from the top of the hills and from the bosom of the 
vallies, and bring them home as trophies of your victory. 

If not able to begin with walking, ride as often as possible in a 
carriage. The jolting of a vehicle will jog the blood along much 
better than no exercise. 

Horseback riding is still better. It combines, in some measure, the 
passive exercise of carriage riding, with the active exertion of walk- 
ing on foot. 

Numerous other modes of exercise may be resorted to with advan- 
tages. Dumb-bells, adapted in size to the strength of the patient, and 
used with caution, are highly serviceable. The battledoor, the foot- 
ball, jumping the rope, pitching quoits, and the athletic sports of the 
gymnasium, all have their appropriate place. The greater the variety 
the better, as by it all parts of the system are brought into play, and 
both the mind and the muscles get the change which they need. 

It is hard to impress patients with the importance of this subject. 
Say what you will, they somehow or other get the idea that a mod- 
erate amount of exercise, taken when they feel like it, is all that is 
required. Fatal mistake ! Whatever the physician may do, the pa- 
tient has a great deal to do for himself. He must strive to develop 
his physical powers to the utmost. He must train himself as runners 
and fighters do when preparing for their surprising feats ; for he is 
running against the swiftest disease (or the surest winner) of our cli- 
mate, and fighting with the elements. 

If he regards life as not worth this exertion, of course he will not 
make it ; but I beg him to consider that without it, recovery will be 
uncertain, and in many cases, impossible. Do as I have directed, and 
if your medical attendant is skilful, the current of health will, in 
many cases, begin to flow back to you. Life will renew to you its 
policy of insurance, and multiply your days. 

Travelling. — Consumptive patients have generally been sent to a 
southern climate. But where the case involves dyspepsia and affec- 
tions of the liver, low latitudes are generally unfriendly. Liver com- 
plaints are the bane of a southern climate, and a sallow complexion 
is the inheritance of a southerner. 

Tubercular persons, chilled by our northern climate, are sometimes 



DISEASES OF THE CHEST. 231 

temporarily relieved by the warmer atmosphere of the south. But 
the relief is only temporary ; for, having lost the power, as they im- 
agine, to bear the frowns of our northern sky, they are dying, and 
will die anywhere unless they recover this power. And the way to 
retrieve a lost advantage over an enemy, is, not to retreat to a point 
where recovery will be harder, but to meet him at once. If the con- 
stitution cannot bear up against an enemy under the bracing of a 
northern atmosphere, it will be still harder to do so under the wilting 
of a southern. 

After all, the objects aimed at should be change and travelling. The 
exercise involved, the constant exertion required in getting from place 
to place, the agreeable sensations produced by the motion of cars 
and steamboats, the ever varying change of sights and sounds, and 
the constantly increasing stock of one's ideas of men and things, — 
these are what rally the constitution, and open anew the springs of 
life. 

Especially should all journeys for health be taken, if possible, with 
an object in view. Let the consumptive start with the view of see- 
ing the cave of Kentucky, the prairies of the West, the great lakes 
of the North, the falls of Niagara, the fortress of Quebec, the Sag- 
uenay river, the doctor, who he has reason to think will cure him, — 
anything which he is willing to make exertion to see, and that he is 
sure his eyes will rejoice in beholding. 

I have thus spoken of consumption more at large than of other 
complaints, because it is the great disease of the world, and is in- 
creasing with the advancement of civilization. 

Acute Bronchitis. 

This is an acute inflammation of the mucous membrane lining the 
air tubes in the lungs. It is generally quite a serious disease. 

Physical Sig'iis. — The sound upon percussion is generally good. If 
there be any dulness, it is commonly in the lower and back part of 
the chest. 

The breathing murmurs are sometimes more, sometimes less in- 
tense than natural. Occasionally they are almost extinct. 

In the early stage, sibilous and loud rattles. 

In the more advanced stage, mucous rattle. 

Now and then sub-crepitant rattle accompanies the inward-drawn 
breath. 

General Sjniptoms, — The disease begins with chills followed by 
i fever ; tightness across the chest, difficulty of breathing, hoarseness, 
I loss of strength, costive bowels, and a quick and hard pulse. Water 
1 runs from the eyes and nostrils, and there is a dry, harsh, croupy 
i cough. 

j After a few days, mucous begins to be raised. This expectoration 

gradually becomes more copious, and is opaque, yellowish, or green- 
ish, and occasionally streaked with blood. This mucus is very ropy, 
, and adheres to the vessel. 



232 DISEASES OF THE CHEST. 

There is more or less pain in the chest ; pain across the forehead, 
which is increased by coughing ; and a pale and anxious counte- 
nance. 

In severe cases, the tightness across the chest is extreme, with a 
sense of suffocation, causing the patient to call for the opening of the 
windows. There is great difficulty of breathing ; a paleness and liv- 
idity of the cheeks and lips ; a loud wheezing and rattling in the 
throat, followed by cold sweat, insensibility and death. 

In children the disease comes on like a common cold, attended by 
a sore throat, a great desire to drink, but a disinclination to take 
food. But two or three swallows of drink can be taken at a time 
for want of breath. The phlegm is frequently vomited up spontane- 
ously. 

Observations. — The loud and sibilous rattles are produced by simi- 
lar causes, namely, the passage of air along tubes whose interior is 
dry and rough from inflammation, or whose calibre is contracted or 
altered in form by the swelling of the membrane, effusion upon its 
inner surface of a tough mucous substance, or a pressure upon its 
external surface of tubercles, swollen glands, aneurismal tumors, 
etc. The two sounds differ mainly in the key upon which they are 
pitched, — the sonorous, or low-keyed, coming from the larger tubes ; 
the sibilous, or high-keyed, from the smaller, — just as the low notes 
of an organ come from the large pipes, and the high notes from the 
small ones. 

The sibilous rattle has been compared to the chirping of birds, the 
squeaking of puppies, the whistling of air passing through a key- 
hole, etc. ; the sonorous, to the snoring of a sleeping person, the coo- 
ing of doves, and the sound of the bass string of the violincello rub- 
bed with the finger. 

Causes. — It is generally brought on by a sudden cold, by changes 
of the weather, and by inhaling irritating substances. It is a second- 
ary result, too, of scarlet fever, measles, small pox, hooping cough, 
and the remittent fever of infants. 

Treatment. — In mild cases, give warm balm or flax-seed tea, hot 
lemonade, or other similar drinks, — at the same time, soaking the 
feet in hot water, and, on retiring to bed, apply bottles of hot water to 
the feet and sides, to produce sweating. If the bowels be costive, 
some gentle physic, as rhubarb and magnesia, or salts and senna, may 
be taken. 

In the case of infants, an emetic of wine of ipecac, or compound 
tincture of lobelia, should be given, and followed with slippery elm 
and flax-seed tea. The compound tincture of lobelia, with tincture 
of veratrum viride, may be continued for a time as an expectorant. 

In more severe cases, both of adults and children, an active emetic 
is required, — perhaps the compound powder of lobelia is as good as 
any. This must be followed with tincture of veratrum viride, in full 
doses, so as to reduce the pulse at once, and keep it down to the 
natural standard. This is one of the very best articles in this com- 
plaint, and will generally very much lessen its violence and duration. 



DISEASES OF THE CHEST. 233 

If there is much difficulty of breathing, the air of the room must 
be kept moist, as recommended in croup. 

The room should also be kept warm, — decidedly warmer than in 
the case of other fevers. 

A gentle perspiration should be kept up by small doses of com- 
pound tincture of Virginia snake-root, and by frequently bathing the 
surface, or else by tincture of veratrum. 

INIustard should be applied to the chest, and to the soles of the feet. 

The cough may be managed by preparations (104) (106) (110), 
freely given. 

The diet should be confined to barley-water, toast-water, apple- 
water, rice-water, and a solution of gum arable. 

Chronic Bronchitis. 

This is an inflammation of the mucous membrane of the air-tubes, 
which continues a great length of time, without any sudden or re- 
markable changes. 

Physical Sig'ns. — The percussion-sounds are similar to those of 
acute bronchitis. When a bronchial tube is dilated, we sometimes 
have dulness around the dilated part. 

The breathing murmur is always accompanied by a mucous, sono- 
rous, or sibilant rattle, — sometimes by a subcrepitant. 

When dilatation of the tubes exists, the intensity and duration of 
the sound of the ingoing breath is decreased^ — of the outgoing 
iticreased. 

In this state of the tubes, we also have cavernous breathing, bron- 
chophony, sometimes pectoriloquy, and bronchial or cavernous cough. 

General Sjiuptoms. — A cough is generally present, which is in- 
creased in wet weather, and by every slight cold. This comes on in 
paroxysms ; is generally worse in the morning ; and is relieved by 
raising freely. The matter raised is generally yellowish, but some- 
times whitish and sticky ; and in the latter stages, is thick, and some- 
times very much like that of consumption. Indeed, the disease often 
ends in bronchial consumption. 

Remarks. — The breathing is bronchial or cavernous when the di- 
lated portion of the tube is empty ; — if it contain fluid, the mucous 
rattle will be heard. 

Dulness on percussion will exist if a dilated tube press upon the 
surrounding portion of lung so as to condense or make it solid. 

Dilatation of the tubes occurs only in chronic bronchitis of long 
standing. Its physical signs are much like those of a cavity in ad- 
vanced consumption. The examiner may learn to distinguish them 
by considering that in consumption, dulness precedes the cavity^ while 
in bronchial dilatations, the cavity precedes dulness. 

The dilatation or swelling out at some point of a bronchial tube, is 
caused by obstructions to the passage of air through it, — just as an 
India-rubber tube, partially closed up at a given point, will bulge out 

30 




234 DISEASES OF THE CHEST. 

just in front of the obstructed place, when air is forcibly blown 
through it, and just as the left ventricle of the heart enlarges when 
the blood is obstructed in its passage through the aortic valve. 

Causes, — It often occurs as the result of acute bronchitis, and also 
of measles, hooping-cough, etc. But taking cold, and damp and change- 
able weather, are more frequently its causes. It most often follows 
chronic inflammations of the throat, which, being neglected, gradually 
creep down the windpipe into the tubes, and become very obstinate 
in their character. 

Treatment. — Medicinal inhalation is one of the best remedies for 
this complaint. The inhaling powder has, in many cases, great effi- 
ciency. The dose is about what can lie on a ten cent piece. It 
should be used once a day, in an instrument represented in the cut. 

This instrument I had constructed in 1850. It consists mainly of 
a glass tube and a receiver, — the latter being something like a tube 
vial, pierced with fine holes around 

the lower end. The powder is rm. 92. 

poured into the receiver, which is [Patented March 16, 1852.] 

placed in the larger tube, and 
twirled between the thumb and 
finger while inhaling. 

"When the powder cannot be 
easily got down into the tubes in the lungs, — as often happens, — 
the inhalation of medicated vapor will do better. If the expectora- 
tion be difficult, the expectorant inhalant, described under " consump- 
tion," should be used ; if the expectoration be too profuse and free, 
the astringent inhalant must be taken. 

The cough preparations recommended for consumption, also (113) 
(112), will be the proper ones in this complaint. 

The daily alkaline bath, and brisk friction, are particularly service- 
able. 

Out-door exercise is almost as necessary in this disease as in con- 
sumption. 

Enlargement of the Air Cells. — Emphi/sema. 

This disease consists in enlargement of the air cells, the obliteration 
of their vessels, and the wasting of their walls. 

Physical Sig'ns. — Thumping upon the chest gives a clearer and 
louder sound than natural, — one which is tympanitic, or drum-head 
like. 

The murmur of the ingoing breath is diminished both in duration 
and intensity, — of the outgoing breath, it is increased. 

Dry, crepitant rattle attends the ingoing breath only ; occasionally, 
sibilous rattle. 

General Symptoms. — Habitual shortness of breath, and very great 
difficulty of breathing, occurring in paroxysms, which cause the pa- 
tient to rush to the open window for air. 



DISEASES or THE CHEST. 235 

There is generally a cough, and the matter raised is frothy, liquid, 
and mucous, or watery. 

The face has a peculiar dusky color, and the countenance an anx- 
ious, melancholy expression. The nostrils are thick, and the lower 
lip full. The muscles of the neck are large, and the gait of the pa- 
tient is stooping. The strength is wasted in proportion to the diffi- 
culty of breathing. 

Emphysema tends to produce disease of the heart, Bright's disease, 
and venous congestions in the head. 

Observations. — The tympanitic sound is caused by the increased 
amount of air in the cells. 

The air cells having lost their elasticity, the air, in a great degree, 
remains in them^ — not passing in and out, — hence the absence of the 
vesicular murmur. 

The crtoitant rattle attends the ingoing breath only, and is sup- 
posed to arise from the expansion of lungs which are in a drier state 
than natural. It has been compared to the sound produced by blow- 
ing into a dried bladder. 

Treatiiieut. — To whatever extent the air-cells are destroyed, to that 
extent, of course, the disease is incurable. It may, however, be pal- 
liated and relieved to a great extent. 

Generally, bronchitis exists in connection with emphysema ; and 
when this is found to be case, the remedies for that disease must be 
employed. 

The inhalation of tincture of stramonium, in one or two teaspoon- 
ful doses, the same as the alterative inhalant is used, will be useful. 

To be taken internally, an excellent preparation may be made by 
uniting one dram of ethereal tincture of lobelia, with two drams of 
tincture of ipecac, and two ounces of ammoniac mixture. The dose 
is one to two tablespoonfuls. Half grain to grain doses of extract of 
cannabis indica, are excellent to relieve the difficulty of breathing. 

The diet must be very carefully regulated, as overindulgence at the 
table aggravates the symptoms. 

Change of air is often highly beneficial ; but it is impossible to 
predict its effects beforehand in each individual case. 

Swelling of the Lungs. — Hi/pertrophy of the Lungs, 

This can hardly be regarded as a disease. It generally takes place 
in but one lung, and is the result of the inaction of the other. Thus, 
when one lung is diseased, the other has to do the work of both ; and 
being overworked, it enlarges as the heart, or an arm does, when very 
much exercised. 

The only treatment required is to eat sparingly, and exercise with 
great moderation, so as not to increase the rapidity of the breathing. 

Pulmonary Apoplexy. 

This is generally the result of a disease of the heart, particularly 
of the mitral valve. 



236 DISEASES OF THE CHEST. 

Physical Signs. — Percussion yields a clear sound, except where 
the engorgement of blood is large, and near the surface, — in which 
case, it is dull. 

The sound of breathing is feeble or absent over a limited space. 

Bronchial breathing is heard in some places, and bronchophony in 
part, in the same regions. 

Mucous rattle is also heard. 

Observations. — In this disease the small air-tubes and air-cells are 
the seat of bleeding ; and the blood becoming coagulated here, closes 
these vessels against the entrance of air. This explains the feeble- 
ness or absence of the breathing murmur. 

The fluidity of blood in the immediate vicinity, gives rise to the 
mucous rattle. 

General Symptoms. — These are, difficulty of breathing, tightness, 
and dull pain in the chest. The mucus raised is tinged or streaked 
with blood. The blood raised is darkish, and dirty-looking. This. 
last symptom, the dirty look of the blood, is peculiar in this disease. 

Treatment, — The most important remedy is dry-cupping upon the 
chest. This will often arrest the disease at once. Counter-irritation 
by croton oil is also useful. A free movement of the bowels by a 
preparation containing croton oil, or elaterium (31) (33), has an ex- 
cellent effect 

Air in the Chest. — Pneumothorax, 

This disease consists in the presence of air in the cavity of tlie 
pleura. Generally, there is also water in the pleural sac at the same 
time ; the water, being the heavier fluid, occupying the lower part of 
the cavity, and the air the upper part. 

Pln'sical Si«;ns, — Tympanitic or drum-like sound over the upper 
part of the side. Dull sound over the lower part. Breathing mur- 
mur diminished or suppressed. Amphoric breathing. Metallic tink- 
ling. 

General Symptoms. — Great oppression of the chest, and difficulty 
of breathing ; generally attended by palpitation of the heart, and fre- 
quently by severe pain under the breast-bone, on the affected side. 
The patient generally has to remain in the sitting posture, and cannot 
lie an instant on the sound side. 

If, on percussion, one side of the chest sounds louder than the other, 
and the breathing murmur is heard distinctly on the side which gives 
only a moderate sound, and is not heard at all on the loud-sounding 
side, we may be sure it is a case of air in the chest. 

Observations. — The metallic tinkling is like the sound produced by 
dropping a pin's head into a metallic dish, or like the distant tinkling 
of a sheep-bell, or the gentle pulling of the string of a violin. 

It is supposed that when the fluid in the cavity of the pleura hap- 
pens to be higher than the orifice, the air, when it enters at each 



DISEASES OF THE CHEST. 237 

in-drawn breath, forces its way up through the fluid, in the shape of 
bubbles, and, bursting at the surface, gives the tinkling sound. This 
sound is sometimes produced, too, by the falling of drops of liquid 
from the upper part of the cavity, upon the surface of the fluid. 

The amphoric breathing is like the sound produced by blowing 
obliquely into an empty cask. One writer says he heard the same 
sound when out shooting in a rough day, produced by the wind blow- 
ins: sidewavs into the orun-barrel. 

Treatiiieut. — I would recommend the use, two or three times a 
day, of the antiseptic inhalant, mentioned under the head of con- 
sumption. 

To this should be added dry-cupping over the whole chest, which 
generally gives great relief. Blisters may also be used. 

Sweating must be encouraged in the manner recommended under 
acute bronchitis. 

For the difficulty of breathing, give half grain doses of cannabis 
indica, or five drop doses of tincture of aconite, or one-sixth of a 
grain doses of morphia. Extract of belladonna, or of stramonium, is 
also worthy of trial. 

Water in the Chest. — Hi/drothorax. 

This disease consists in a collection of water in the cavity of the 
pleura. 

Physical Si«:ns. — There is a dull sound over the effusion. 

The breathing murmur is diminished, and gradually disappears 
altogether over the space occupied by the effusion. 

P^onchial breathing is heard in the same part. 

When the amount of fluid is small, egophony is heard in the mid- 
dle regions of the chest. 

Bronchophony is heard when the effusion is larger. 

General Symptoms. — Either upon lying down, or using active bodily 
exercise, the patient finds his difficulty of breathing increased. When 
in bed, he lies with his head and shoulders raised, which, by causing 
the fluid to settle at the bottom of the cavity, prevents, in a measure, 
its pressure upon the lungs, and gives him a little rest. His sleep is 
interrupted by sudden starts, with alarm and terror. The pulse is 
hard, the thirst great, the urine scanty and high-colored, and has a 
sediment. After a time, the feet swell, the face is pallid and livid, 
and the countenance expresses anxiety and alarm. There is a short, 
dry cough. 

When the quantity of fluid in the chest becomes large, the patient 
cannot lie down at all, and only gets short and disturbed naps in the 
sitting posture. 

Of all the symptoms, the starting in sleep is the most certain sign 
of the disease. 

Causes. — In some rare cases, this may occur as a primary disease, 
— that is, as a disease not dependent upon any other as its cause. 



238 DISEASES OF THE CHEST. 

The greater number of cases, however, are secondary. They arise 
from organic disease of the heart, or liver, or stomach. Inflammation 
of the pleura is a very frequent cause. 

A plethoric, or full state of the system, predisposes to this com- 
plaint, — particularly in those persons who indulge freely at the 
table. 

It may arise, too, from the striking in of skin eruptions ; from the 
free use of liquors ; and from frequent excessive bleedings or purg- 
ings. 

Treatment. — Dry-cupping is a valuable remedy, and should always 
be practised. 

The chest should be painted with the tincture of iodine,'and a good 
degree of substantial soreness be kept up. 

The internal remedies are purges (31) (14) (30), and diuretics 
(128) (129) (130) (131). 

The iodide of potassium, in doses of five or six grains, once in 
three or four hours, is an excellent remedy. The following is a good 
form of taking it, — iodide of potassium, one ounce ; fluid extract of 
pipsissewa, two ounces ; water, half a pint. Dose, one teaspoonful. 

The skin should be bathed and rubbed daily. 

Pleurisy. — Pleuritis, 

Pleurisy, or pleurisy fever, as it is sometimes called, is an inflam- 
mation of the pleura, or the membrane which lines the chest, and, at 
the same time, is folded back so as to cover the outer surface of the 
lungs. 

The pleura, as is elsewhere explained, is a short sac or bag, whose 
inner sides are kept moist, so that they may slide easily upon each 
other as they are moved by the alternate contractions and expan- 
sions of the Jungs in the act of breathing, and whose outer sides are 
made to grow, — one to the inside of the chest, and the other to the 
outside of the lungs. 

Pleurisy and lung fever, then, must be kindred diseases, and exist, 
more or less, together. In truth there is almost always some affection 
of the pleura in lung fever, and some affection of the lungs in pleu- 
risy. The pain in lung fever is owing to some inflammation of the 
pleura ; and the appearance of the rusty-colored phlegm in pleurisy 
indicates that the lungs have been reached by the inflammation of the 
membrane which covers them. 

Physical Sig'iis. — Dulness on percussion, at the lower part of the 
chest, which ascends as the effusion of water increases. 

K the eff'used fluid is not great, there is puerile breathing at the top 
of the lung. 

Friction sound is heard occasionally. 

Egophony is heard when the amount of fluid in the pleura is 
small. 

As the amount of water increases, bronchophony appears. 



DISEASES OF THE CHEST. 239 

General Syiuptoms. — This disease is most frequently introduced 
by shi verifies, which are soon succeeded by high fever, with a pecu- 
Uarly hard, resisting pulse ; sharp, stabbing' pain in the side, — gener- 
ally just below the nipple, but sometimes extending to the shoulder, 
arm-pit, and back ; hurried and interrupted breathing ; and a short, 
drv coue^h. 

The pain is greatly aggravated by motion, coughing, or an attempt 
to take a long breath. It holds the patient under constant and power- 
ful restraint. We find him lying upon his back, or his well side ; his 
countenance full of anxiety, — fearing to move, cough, or even breathe 
needlessly ; and often crying out from the keen torture these neces- 
sary acts inflict in spite of all his caution. 

At a more advanced stage, when the tenderness has somewhat 
abated, he will prefer to lie on the diseased side, as this leaves the 
healthy lung more at liberty. 

Observations, — The first effect of the inflammation of the pleura 
is to dry up the moisture with which its inner surfaces are lubricated, 
or made smooth and slippery. As a consequence, these surfaces be- 
come rough, and rub harshly upon each other, and produce a sound, 
in the early stages of pleurisy, like that of rubbing two pieces of wet 
leather together. It may be imitated by rubbing the finger back and 
forth upon a table. It is sometimes a creaking noise, like that of 
new shoes. 

As the disease advances an important change takes place in the 
state of things. Instead of an unnatural dryness, a watery fluid is 
poured out copiously from the inflamed surfaces of the pleural sac. 
This is called the period of effusion. This generally, though not al- 
ways, relieves the pain. But, by compressing the lung, causes dan- 
gerous difficulty of breathing. 

The air-cells are compressed by the effused fluid, and are not pene- 
trated by air. Hence the absence of the breathing murmur. 

The pouring out of water between the layers of the pleura, com- 
presses the lung, and removes it from the walls of the chest. Hence 
the dulness or deadness of sound upon percussion. 

When listening with the stethoscope, the voice of the patient sounds 
feeble and interrupted, like the bleating of a goat, and is hence termed, 
egophonp, or goat-voice. 

This peculiar voice is heard only when the eff*usion of water has 
been moderate in quantity, and only a thin layer of liquid lies be- 
tween the ribs and lung. It is caused by the voice passing over this 
thin layer, which is thereby thrown into vibrations, or wavy, quiver- 
ing motions. When thus agitated, the fluid reacts upon the voice, 
making it sharp and tremulous. 

When the effusion has become large, these effects cease ; but an- 
other sign then shows itself, and distinguishes pleurisy from the 
healthy state, and likewise from the solid, hepatized state of the lung 
in lung fever. It may be discovered thus : 

If the hand be laid flat upon the chest of a healthy person, while 
he is speaking, a vibration or thrill will be felt. If, in like manner, 



240 DISEASES OF THE CHEST. 

the hand be laid upon the chest of a person having lung fever, with 
hepatized lung, this thrill will be found still more perceptible. But 
when the hand is placed over the place of watery effusion on the chest 
of a person having pleurisy, there will be discovered, when the person 
speaks, no thrill ivhatever. The absence of this thrill^ then^ is one of 
the very best signs of pleurisy u'ith effusion. 

Persons recover from pleurisy sometimes very rapidly, before effu- 
sion has taken place. It is then said they have had an attack of dry 
pleurisy. When liquid has been poured out, even in considerable 
quantity, it is sometimes reabsorbed, and the patient recovers per- 
fectly. In other instances, it compresses the lungs, interferes seriously 
with breathing, reduces his strength, and he sinks rapidly. 

Treatment. — The first remedy generally employed in this disease 
is bleeding. This is pushed to the extent of the patient's endurance, 
and in many instances repeated several times. This commonly re- 
lieves the pain. 

As a general thing, I am opposed to bleeding, and am even reluc- 
tant to recommend it in pleurisy. Yet if there is a human ailment 
which will justify it, pleurisy is that one. 

Sweating should be encouraged immediately. The compound 
tincture of Virginia snake root, given every half hour, in teaspoonful 
doses, will generally produce a free perspiration, and give immediate 
relief. It may be given in infusion of catnip, balm, or pleurisy root. 
At the same time, the affected side should be fomented with hops, 
tansy, wormwood, etc., applied very hot. 

If this does not afford relief, or only partial relief, give an emetic 
of the compound powder of lobelia, and follow it with the compound 
powder of jalap, or the compound powder of leptandrin, or prescrip- 
tion (31), as physic, — at the same time, keeping up the perspira- 
tion, with full doses of tincture of veratrum. 

To procure sleep and perspiration at the same time, Dover's powder 
may be given in six grain doses. 

For the fever, nothing is equal to the tincture of veratrum viride. 

The diet must be of the very lightest kind. 

When absorption of the fluid does not take place, a puncture is 
sometimes made, through the walls of the chest, and the water drawn 
off. This operation is called paracentesis thoracis, and is generally, in 
uncomplicated cases, entirely successful. When this is not done, let 
the affected side be painted daily with tincture of iodine, keeping up 
considerable soreness, and giving iodide of potassium at the same 
time, (146). 

Lung Fever. — Pneumonia. 

This disease, by common usage, has been called a fever ; but by 
physicians it is reckoned one of the inflammations. It is inflamma- 
tion of the lungs or lights ; and whatever fever there may be, results 
entirely from this local inflammation. 



DISEASES OF THE CHEST. 241 



Sio'US and Sjiiiptoms, — A patient suffering with lung fever, is gen- 
erally found lying upon his back, with some pain in the side ; more 
or less difficulty of breathing ; a cough, at first dry, but soon accom- 
panied by raising a thick, sticky, rusty-colored matter, composed of a 
mixture of phlegm and blood. As the disease increases in severity, 
this matter will become more sticky and tenacious, so that it will ad- 
here to a spit-cup turned upside down. There will be more difficulty 
of breathing, greater prostration, and perhaps some delirium. 

For the purpose of more clearly describing this complaint, it is 
found convenient to divide it into three stages, or degrees of progress. 

Fii'St Stiig'e, — This is called the stage of engorgement The lungs 
during this stage are engorged or crowded with blood. If we could 
inspect them, we should find the inflamed portion redder^ thicker^ and 
heavier than usual. "We should find them weaker, that is, more 
easily torn than in the natural state ; with less air in them, and con- 
sequently' crackUng less upon pressure, — yet not entirely destitute of 
air and crackling, and not so heavy as to sink in water. Rapping 
upon the chest at this period gives out a flatter, duller, or less hollow 
sound than usual. On applying the stethoscope, we hear less of the 
natural rustling sound of health ; and, either mingling with, or over- 
coming it, we hear a minute crackling sound, as the air passes in and 
out in breathing. 

This crackling has been compared to that produced by fine salt 
thrown upon red-hot coals ; or by that of rubbing a lock of fine hair 
between the thumb and finger near the ear. It is caused by small 
bubbles of air being forced along the moist and sticky sides of the 
small tubes and air-cells. It is heard only while the breath is being 
drawn in. 

Second Sta«*e. — If the inflammation advances to the second stage, 
the swelling of the diseased lung increases so as to force out the air 
entirely, and it becomes solid^ and wholly useless for the purpose of 
breathing. In solidity and general appearance, it resembles a piece 
of liver. Hence it is said to be hepatized, or liverized ; and this is 
called the stage of hepatization. 

As the lung grows more solid, its vitality and strength diminish ; 
it is not near as strong as a piece of healthy liver, though it looks like 
it ; it is soft and easily broken ; indeed it seems to be in a state of 
commencing decay or rottenness. Hence some writers, in order to 
be more precisely correct, call this the stage of red softening. 

With increased solidity, there is of course increased dulness on 
percussion. When the stethoscope is applied to the chest, we hear 
no sound of air passing into and out of the diseased lung ; no natu- 
ral rustling, or minute crackling ; but in their stead, we have a kind 
of whistling, produced by the air passing back and forth in the wind- 
pipe and its branches, but finding no entrance into the solidified air- 
cells. The breathing sometimes sounds like a sort of puff", — owing 
to the column of air rebounding when refused admission to the 
closed-up cells. 

The general symptoms now increase in severity. There is greater 

31 



242 DISEASES OF THE CHEST. 

difficulty of breathing ; the phlegm is more gluey ; perhaps some de- 
lirium shows itself ; and the patient grows weaker. 

Third Stag'e. — At this period, the lung changes from red hepatiza- 
tion^ or red softening-, to gra?/ hepatization, or gray softening, and mat- 
ter is now found diffused through its whole substance. The percus- 
sion sounds are much the same as in the second stage. On listening, 
we hear more of the rattling sound produced by disturbed phlegm. 
The matter raised is thinner, — more like liquid ; and looks like 
prune-juice. The symptoms generally indicate that the patient is 
sinking. Patients may recover from the first and second stages, but 
rarely from the third. 

Treatment, — This is one of the diseases in which the treatment 
generally begins with bleeding; but I cannot recommend it. I be- 
lieve it may be dispensed with, and the patient recover quite as well. 

The first thing is generally an emetic of tartrate of antimony, or 
pulverized ipecac, or compound powder of lobelia. The next thing 
aimed at should be to produce sweating by the use of the compound 
tincture of Virginia snake root, hot fomentation of bitter herbs to the 
chest, and bottles of hot water to the sides, etc. If the fever be high, 
and the pulse rapid, it is better to promote sweating, and loosen the 
phlegm, by the use of the tincture of veratrum viride, in three to ten 
drop doses every hour. This tincture will act more decidedly for this 
purpose, and to reduce the pulse and fever, than any other article we 
have. 

Blisters are sometimes applied; but they are, inconvenient, as they 
hinder a proper examination of the chest. Mustard will generally 
answer every purpose. It should be put on and taken off several 
times, and when the surface grows sore, it must be changed to an- 
other, so as to affect the chest extensively. 

If the bowels be costive, they must be opened with some prepara- 
tion of salts (7) (18) (20) (27). 

The drink must be marshmallow, slippery elm, flax-seed, etc., and 
the diet confined to barley w^ater, lemonade, sour apple water, thin 
Indian meal and arrow-root gruel, crust-coffee, and the like. 

As the fever abates, the cough will need special attention, and to 
keep this quiet, and make the raising easy, preparations (104) (112) 
(110) will be suitable. 

Should the patient be feeble and low when the fever is gone, give 
tonics (63) (64) (69) (73) (84) (81). 

Guard especially against a relapse. 

Typhoid Lung Fever. — Typhoid Pneumonia. 

This is an inflammation of the lungs, differing from the preceding 
only in the character of the fever attending it, which is of a low, 
typhoid character. The disease, like typhoid fever, is characterized 
by great debility and prostration. 

Symptoms. — These are a combination of the symptoms of pneu- 
monia and of typhoid fever. The disease begins with great weariness, 



DISEASES OF THE CHEST. 243 

lassitude, dizziness, pain in the head, back, and limbs. Soon there is 
much dithculty of breathing, tightness across the chest, with a dry, 
short, hacking cough. 

As the diseaes advances, the active symptoms pass away ; there is 
a dull pain across the chest ; drowsiness is very apt to come on, with 
the various symptoms of sinking peculiar to typhoid fever. The skin 
is harsh and dry, the temperature uneven, the tip and edge of the 
tongue red, and the middle covered with a yellow or brown fur. The 
bowels are tender, swollen, and drum-head-like ; while, there is often 
a diarrhoea, — the discharges having a dirty -yellow color. 

Treatmeut, — This should be like the treatment of pneumonia and 
typhoid fever united. 

Great care must be taken not to use reducing remedies. While 
active purging must not be used, yet, if there are symptoms of an 
inactive state of the bowels, podophyllin and leptandrin (34) (39) may 
be employed with advantage. 

When there are symptoms of great depression, use tonics (46) (48) 
(50) (53) (60) (64) (67) (73), taking care to keep the cough loose by 
flax-seed, slippery elm, and marshmaliow tea, and by some external 
irritant 



HEART DISEASES, 



Life rests upon a tripod, — the brain, the lungs, and the heart. 
These are equally important to its well-being and continuance. 

In substance, the human heart is a bundle of muscles, so put to- 
gether as to bear the greatest possible amount of work. In size, 
shape, and look, it is much like the heart of the hog. I wish it never 
had a likeness to it in its moral nature. 

The heart is enclosed in a case or sac, called the pericardium. It 
lies between the two lungs, a little to the left side of the chest. Its 
point is under the sixth rib on the left side, and its lower surface rests 
on the diaphragm, — a horizontal partition between the chest and belly. 
The heart is double. It has four cavities, — two for receiving the 
blood, which are called auricles^ and two for driving it out, called 
ventricles. 

The venous, or dark blood, is brought from all parts below, and 
emptied into the right auricle through the ascending' vena cava, and 
from all parts from above, and poured into the same cavity through 
the descending vena cava. From this it passes into the right ventri- 
cle, w^hich contracts, and forces it through the pulmonary artery into 
the lungs, where it becomes red, and passes into the left auricle 
through the pulmonary vein, thence into the left ventricle, which con- 
tracts, and throws it out through the great aorta to all parts of the 
body. Fig. 93 gives a good idea of the circulation through the heart 
and lungs. 

The heart is divided into two sides, which are separated from each 
other by a muscular partition, — each side having an auricle and a 
ventricle. 

The auricles have comparatively thin walls, as they are only used 
j for reservoirs. The walls of the ventricles are much thicker, being 
j used, — particularly that of the left side, — for forcing the blood over 
I a large surface. 

I Between the auricle and ventricle on the right side, are three folds 

I of triangular membrane, called the tricuspid valves. Between the 
i auricle and ventricle on the left side, are three valves, called mitral. 
j At the beginning of the pulmonary artery, and the aorta, are three 

I half-moon shaped folds of membrane, called semilunar valves. 
j The office of all these valves is, to close after the blood has gone 

! through, and prevent its flowing back while the cavity is being again 
j filled. They do the same duty, in fact, as the valves of a pump. 



HEART DISEASES. 245 



Through this he^art, tlius constructed, all the blood in the body, — 
about twenty -eight pounds, — passes once in about one minute and a 
half. This is rapid work ; and when we consider that the heart 
works in this way through the Avhole life, resting not, day or night, 
we cannot w^onder that it gets out of order. 

Fig. 93. 




The whole heart is seldom affected. The left side is more liable 
to disease than the right. 

Impulse of the Heart. 

The ear when placed over the heart, feels, at each beat, a slight 
shock. This is felt at the same time the first sound is heard. This 
impulse is caused by the apex or point of the heart being thrown up 
against the ribs by the contraction of the ventricles. It is felt best 
between the cartilages of the fifth and sixth ribs on the left side. 

The Sounds of the Heart. 

On applying the ear to the chest just over the heart, two sounds 
are heard. The first one is dull and slightly prolonged ; the second 
is a shorter and smarter sound, having a sort of clack. These occur 
in pretty rapid succession, and then comes a brief interval. And this 
round of action, first a long and dull sound, then a short and smart 
one, and then an interval, — called the heart's rhythm^ — is repeated 
continually. If the space of time occupied by the rhythm be divided 
into five parts, the first sound will take about two parts, the second 
one, and the interval of repose, the remaining two. The first sound 
is heard about the time of the contraction of the ventricles, and is 
therefore called the systolic sound ; the second is synchronous with 



246 HEART DISEASES. 



the opening of the ventricles, and is called the diastolic sound. 
The syllables too-to — too-to, very fairly represent the two sounds of 
the heart. These sounds are heard over the largest space in lean 
persons. 

Percussion Sounds. 

If the ends of the fingers be struck upon the chest over the heart, 
a dull sound will be heard over a space from one and a half to two 
inches square, — beginning at the fourth rib on the left side, and ex- 
tending down nearly to the sixth. The dulness is diminished by 
lying upon the back, and increased by leaning forward, and by taking 
a full breath. The deadness of sound is caused by the heart being 
a partially solid body. The lungs which surround it, yield a clear 
sound. 

If a solid substance, as large as the heart, were placed on the inside 
of a drum, against the head, only a dead sound would be obtained by 
striking on that spot ; everywhere else, the sound would be louder. 

Altered Sounds of the Heart. 

These sounds are changed by disease in a variety of ways, both as 
to their character and duration. One or both sounds may be turned 
into a noise like the blowing of a pair of bellows. This is called the 
bellows sound. When this sound is very harsh, it may become like 
the noise of a rasp, or file, or saw. These altered sounds are all pro- 
duced by an altered condition of the valvular passages through which 
the blood passes. If you build an aqueduct of equal dimensions 
throughout, and smooth on the inside, you may send a certain vol- 
ume of water through, at a given speed, without noise. But if you 
make sudden contractions in the aqueduct, or allow large stones to 
project into it, and then attempt to send through the same body of 
water, at the same rate of speed, you will hear all sorts of noises. 

Enlargement or Hypertrophy of the Ventricles. 

This is simply a thickening, or an increase of bulk, in the walls of 
the ventricles. The muscles composing the walls of one or both of 
these cavities, grow thick and large. 

Physical Sig'ns, — Impulse stronger than natural. When consider- 
able, it is accompanied with a lifting and heaving of the parts. Dull 
sound on percussion over a larger space. First sound of heart pro- 
longed ; second sound feeble. The interval of silence, shorter than 
natural. In bad cases, the second sound is nearly extinguished. 

General Symptoms. — Hypertrophy of left ventricle gives a strong, 
prolonged, and tense pulse. Palpitation more constant than in any 
other disease of the heart. In advanced stages, the patient is easily 
out of breath. There is a rush of blood to the head on making exer- 



HEART DISEASES. 247 



tion, or stooping, with more or less throbbing and lancinating head- 
aches, which are aggravated by suddenly lying down or rising up. 
There are vertigo, ringing in the ears, sparks of light and other illusions 
before the eyes; also a purplish, violet or livid color upon the cheeks, 
nose, and lips. In many cases there is a dull, severe, aching pain in 
the region of the heart, and extending towards the shoulder and the 
inside of the arm. 

AVhen the right ventricle is enlarged, there is a swelling of the ex- 
ternal jugular veins. 

Causes. — The walls of the heart are thickened by overivork, in the 
same way that the blacksmith's arm is made muscular and large. All 
muscles grow in the same way. More action sends more blood to 
them, and this causes an increase of nutrition. 

Whatever interposes an obstacle to the passage of the blood through 
the valvular openings, will cause the ventricles which force it through 
to work harder. Hence, obstructions in the semilunar valves cause 
hypertrophy of the ventricles. 

Any excitement of the mind, or any great exertion, which causes 
the heart to beat harder and faster, if it be often repeated, will induce 
a thickening of the ventricles. 

Treatment, — First, remove, as far as possible, all causes of excite- 
ment which produce palpitation. If the head is much affected, apply 
wet cups to the back of the neck. The same may be applied over the 
heart. This will generally improve the symptoms at once. A blister 
placed over the heart will likewise make a favorable impression. 

The meals should be taken at regular intervals, and should be very 
light. The food should be plain and simple, and composed much 
more of vegetable than of animal food. In fact, the diet should be 
so spare as slightly to reduce the strength. 

The patient should be careful never to take violent exercise, or, in- 
deed to be in a hurry about anything. In bad cases, walking up hill, 
or against a strong wind, is often out of the question, and must in 
any case be attempted with great caution. Stair-cases are to be 
shunned as enemies. An attempt to run, even to avoid being left by 
the cars, might, in some cases, prove immediately fatal. Carriage 
riding is not objectionable. 

The passions must be held in the most thorough subjection. Ex- 
citements of all sorts are dangerous, and must be avoided. 

For the first week or two of treatment, active purgatives will be 
useful. For this purpose, epsom salts and senna will answer a good 
purpose, and should be used so as to procure two or three watery 
stools a day. 

In addition to this, some sedative to lessen the force of the heart's 
action, is generally needed, — especially when there is considerable 
palpitation. For this purpose, tincture of black cohosh, and tincture 
of scullcap, or the former with tincture of digitalis (235) (94), are 
quite useful. Three to ten drops of tincture of the American helle- 
bore (veratrum viride) will reduce the action of the heart perhaps 
more efTectually than any other medicine. 



248 HEART DISEASES. 



Dilatation of the Ventricles. 

The several cavities of the heart hold about one and a half ounces 
each. Dilatation is simply an enlargement of these cavities, so that 
they will hold more. And this increase in the size of the cavity in 
simple dilatation is generally at the cost of the walls, which are made 
thinner and weaker, — just as the walls of a bladder are made thinner 
by blowing into it and increasing its internal dimensions. 

Physical Signs, — Impulse more abrupt, and less marked than nat- 
ural. Dull sound on percussion commensurate in extent with the 
dilatation. The first beat of the heart, clearer, louder, and shorter 
than natural, and more nearly resembling the second. 

General Symptoms. — Difficulty of breathing; terrific dreams ; start- 
ing from sleep ; swelling of the feet and legs ; purple, violet, or blue 
color of cheeks, nose, lips, and especially around the eyes ; feeble and 
oppressed palpitation ; various disturbances in the head ; bleeding 
from the nose, stomach, bowels, and womb ; and frequently enlarge- 
ment of the liver. 

Explanations. — The first sound of the heart is short and not well 
marked, in consequence of the muscular walls of the ventricles in 
this disease being thin and in a w^eakened condition, so that every 
stroke they make is short, quick, and spasmodic, instead of strong 
and lifting, as in hypertrophy. For the same reason, the impulse is 
a brief blow dealt the walls of the chest, which gives a slight shock, 
but has not power enough to lift the chest up. The blow is quick, 
because the muscle is thin and can contract quicker than a thick one. 

Dilatation, by thinning the walls of the cavities, enfeebles the heart, 
and shows us an obstructed circulation. Accordingly the blood is 
not transmitted by the left ventricle, and being retained in the lungs, 
it causes a crowded state of the vessels, and difficulty of breathing ; 
also congestion of the brain, with terrific dreams, etc. And this en- 
gorgement of the lungs, being propagated backwards to the right 
heart, great veins, and all their ramifications, produces dropsy of the 
feet and legs, discoloration of the face, passive hemorrhages, and con- 
gestion of the brain, liver, and membranes. Fig. 93 gives an idea 
of how all this happens. 

Treatment. — As in many other diseases, search out the causes, and 
remove them. If it be obstruction of the circulation in the lungs by 
bronchitis, or other complaint, that needs the first attention. If it be 
caused by violent exercise, by strong emotions of the mind habitually 
indulged, or by drunkenness, or any other irregularity of life, these 
habits must be corrected without delay. 

If it be caused by organic disease of the valves of the heart, relief 
cannot be so readily obtained ; but even in these cases, it is to be 
sought and expected. 

The circulation is to be kept as tranquil as possible by a strictly 
quiet and orderly life, and a plain, moderate, unstimulating diet. In 



HEART DISEASES. 249 



this disease, however, it should be more nutritious, and composed to 
a larger extent of meats, than in hypertrophy. 

In some cases the general health and tone of the system will need 
to be improved by bitters (50) (67) (64) (69) (79), mineral acids (60), 
iron ('269) (61), and aromatics (115). The compound mixture of iron 
is a good preparation when this mineral is called for by a low state of 
the blood. 

The stomach should be kept in the best possible condition, as a 
very small disturbance of it, even from acidity, will set the heart to 
beating very violently. 

K hysterical symptoms are present, the compound galbanum pill, 
and valerian (97), and other nervines will be called for. 

In attacks of great difficulty in breathing, immerse all the extremi- 
ties in warm water, and throw a blanket around the patient to pro- 
mote sweating, — at the same time admitting fresh air to satisfy the 
desire for breath. Give a draught, composed of ether, laudanum, 
ammonia, etc. (135). This may be repeated two or three times, at 
intervals of half an hour, or an hour, according to the urgency of the 
case. 

Hypertrophy with Slight Dilatation, 

This is one of the most common complications of heart disease. 
It consists both in a thickening of the walls of the heart, and an en- 
largement of the cavities, — the former being more marked than the 
latter. 

Physical Si^ns. — Both sounds are louder than in any other disease 
of the heart, and are heard sometimes over the whole chest. The 
impulse is strong and heaving, with an abrupt back-stroke. In bad 
cases, the whole person, and even the bed, is shaken by it. The dull 
sound on percussion covers a large space. 

General Symptoms. — The same as those of the two diseases of 
which it is composed, slightly modified by the action of each upon 
the other. 

Dilatation with Slight Hypertrophy. 

This is an enlargement of the cavities of the heart, with a slight 
thickening of its walls ; the dilatation being the predominant disease, 
or greater than hypertrophy. 

Physical Si^ns. — Percussion gives a dull sound in the region of the 
heart, in proportion to its size. The first beat resembles the second. 
The second beat is louder than natural. 

The impulse is a short, quick stroke, which contrasts strongly with 
the slower and heaving one of hypertrophy with dilatation. 

The general symptoms and the treatment are a modification of 
those of the two diseases united in it. It is, however, to be kept in 
mind that the dilatation takes the lead ; and, furnishing the predomi- 
nant symptoms, is specially to be regarded in the treatment. 

32 



250 HEART DISEASES. 



Aneurismal Tumors of the Heart. 

When, from some obstruction in the valves, the blood cannot easily 
pass out of an auricle or a ventricle, its inner walls may become 
unable to bear the distending force, and giving way, let the blood 
through against the outer coats, which stretch, and swell out into the 
shape of a tumor, — the inside of the tumor becoming a regular sac. 
Such a state of things constitutes an aneurism of the heart. Of 
course it is incurable. 

Softening of the Heart. 

In this disease the substance of the heart becomes soft, and easily 
broken. It is generally the result of some form of inflammation. 

Physical Sig-ns. — The contractions of the heart being weakened by 
softening, the impulse is reduced in force, and both beats are weaker, 
and often they are intermittent. The first beat becomes short and 
flapping, like the second. 

General Sjinptoms. — A quick, feeble, small, and faltering pulse, 
great anxiety, and a disposition to faint. General languor ; a sallow, 
bloodless, withered complexion, with a purple, livid tint of the lips 
and cheeks, and frequently, general dropsy, from the inability of the 
heart to propel its contents. 

Treatment, — When accompanied by acute inflammation, softening 
is to be treated on the same principles as inflammation of the heart- 
^ase. 

If it be a result of chronic inflammation, it calls for iron, bitters, 
nutritious animal food, and good air. 

Induration of the Heart. 

The muscular substance of the heart sometimes undergoes a hard- 
ening process. It is occasionally so much hardened as to sound, 
when struck, like a hollow horn vessel. The disease is rare. 

It increases the heart's impulse, like hypertrophy ; and it requires 
about the same treatment with that disease. 

Fattj Degenerations of the Heart. 

The heart sometimes becomes overloaded with fat, which is depos- 
ited between the heart-case and the muscular substance, — covering 
the organ all over externally, and in some cases penetrating to some 
depth into its substance. The muscular walls themselves become 
thin and flabby. 

Symptoms. — The sounds of the heart are diminished, — especially 
the first. The pulse is irregular. Pain, and a feeling of oppression 
in the region of the heart, with general signs of retarded circulation, 



HEART DISEASES. 251 



such as congestion of the brain and liver. There is occasionally gid- 
diness, loss of memory, and palpitation. 

Treatiiieiit, — Exercise, mental excitement, and stimulating drinks 
must be avoided ; and the patient must live for one or two years on 
a very light diet, taking but very little animal food. 

Bony and Cartilaginous Productions in the Heart. 

These productions in the heart are fortunately rare. Yet they 
occur ; and the point of the heart, in its whole thickness, is some- 
times changed to cartilage. The ventricles are sometimes so ossified 
as to resemble the bones of the head. 

The symptoms of these degenerations are obscure ; and as such 
cases are not curable, it is of less consequence that we should be able 
to know their precise nature during the life of the patient. The treat- 
ment can only afford temporary relief, and should be such as is pre- 
scribed in other heart diseases with similar symptoms. 

^ Shrinking of the Heart. — Atrophy. 

The heart, like any other muscle, is liable to defective nutrition, 
and in consequence of it may become small. It shrinks, in some 
cases, to the size of an infant's heart. 

The complaint is generally caused by whatever reduces the general 
flesh, as consumption, diabetes, chronic dysentery, cancer, and exces- 
sive loss of blood. 

It can hardly be called a disease. Persons who have it are less 
subject to inflammatory diseases than others, though they faint from 
slight causes, and have nervous affections. 

Treatment. — If its causes can be discovered, treat them ; if not, 
the treatment should be the same as for dilatation. 

Acute Inflammation of the Heart-Case. — Pericarditis. 

The pericardium, or heart-case, is a membranous sac, in which 

the heart is contained. It is composed of two layers. The outside 

one is fibrous, dense, and white ; the inside one is serous. The serous 

layer forms the lining of the fibrous one, and then is reflected over 

I the heart, and the roots of the large blood-vessels. 

When the pericardium becomes acutely inflamed, it throws out, 
both lymph, and serum or water. The lymph often causes the two 
I layers of the sac to grow together. 

I Physical Sig*ns. — The impulse is strong when the effusion of water 

I is small, — feeble and unequal when it is large. Percussion yields a 
I dull sound in proportion to the amount of fluid in the sac. 
I When listening with the stethoscope, a rough noise is heard, resem- 

bling either the rasping of wood, the grating of a nutmeg, the rustling 
of silk, or the crackling of parchment. Sometimes it is softer^like 



252 HEART DISEASES. 



the blowing of a pair of bellows. Occasionally, it resembles the 
creaking of a new shoe-sole, or has a low creaking, like the tearing 
of linen cloth. 

"When there is effusion, the ordinary beats of the heart sound dull 
and distant. 

General Sjniptoms. — Acute inflammatory fever generally preceded 
by chills, with pungent pain in the region of the heart, shooting to the 
left shoulder-blade, shoulder, and upper arm. 

Pain increased by taking a full breath, by stretching the left side, 
by percussion, and by pressure between the ribs over the heart. Some- 
times the pain is in the epigastrium, or left hypocondrium. Inability 
to lie on the left side. 

Explairatioii. — The noises mentioned above, are produced by the 
rubbing together of opposite surfaces of the heart-case, made rough 
by the exudation of lymph. The rasping is supposed to be caused 
hy firm and rugged lymph ; the rustling and creaking, by soft and wet 
lymph ; the bellows murmur, by soft and dry lymph ; the creaking, 
croaking, and crackling, by dry^ tough lymph. These sounds may all 
be imitated by rubbing a damp finger upon the back of the hand, 
while listening with the stethoscope applied to the palm. 

Chronic Inflammation of the Heart-Case. 

When acute pericarditis runs for more than ten days or a fortnight, 
it becomes chronic. It is chronic from the beginning, when it runs a 
slow, insidious course, without marked or violent symptoms. 

The symptoms are much the same in kind with those of the acute 
form, only less in degree. This low grade of the symptoms of the 
disease renders it more obscure than the acute. 

Treatment — In the acute form of the disease, apply wet cups over 
the region of the heart, or apply from a dozen to forty leeches to the 
same parts. 

At the same time, move the bowels freely by an injection (247), or 
by a purgative pill (31). 

The strength and amount of the remedies employed in each case, 
must be in proportion to the vigor of the patient's constitution. 

It is of great importance that the treatment should be active and 
prompt, and that the disease should be broken down early. 

Diluent, cooling drinks (132) (129) (298) (299) should be allowed 
as freely as the patient desires, in order to dilute the blood, and ren- 
der it less stimulating to the heart. 

At the same time, five to fifteen-drop doses of tincture of veratrum 
viride should be given every hour, to bring down the action of the 
heart. 

Let the diet be wholly of barley-water, thin gruel, weak tea, or 
arrow root. 

During recovery, the diet must be spare, and the greatest tranquil- 
lity of mind and body be preserved. 



I 
HEART DISEASES. 253 i 



In the treatment of chronic cases, when the cavity appears to con- 
tain fluid, counter-irritation is suitable. Blisters, croton oil, the com- 
pound tar plaster, and especially the tincture of iodine. The diet 
may be a little more nutritious than in the acute form of the disease, 
— embracing hght animal food and broths. 

Inflammation of the Heart. — Carditis, 

This is an inflammation of the muscular substance of the heart. 
When existing alone, it is a very rare disease. Being mixed up with 
other forms of heart disease, it does not require any separate account 
of its symptoms or treatment. 

Acute Inflammation of the Lining of the Heart. 

'Endocarditis, 

The heart is one of the citadels of life. Disease attacks it on all 
sides. In this complaint, it has entered the fort, and taken possession. 
The inflammation is on the lining- membrane. 

Pliysical Si«'ns. — The impulse is violent, abrupt, and regular, as 
long as the circulation through the heart is free, but when this is im- 
peded, it is at first a confused tumult (which generally happens when 
a fort is first taken), and gradually sinks to a feeble flutter. 

The dull sound upon percussion covers a space of from three to 
seven square inches. 

The beats of the heart are generally accompanied or marked by a 
bellows murmur, — the loudness of which depends on the strength of 
the heart's action. 

General Symptoms. — Inflammatory fever. The action of the heart 
being generally violent and abrupt, the pulse corresponds with it, and 
is strong, full, and hard; 

Explanation. — The bellows sound is supposed to depend on the 
inflamed and swollen condition of the valves. 

The dulness on percussion will be slight when the circulation 
through the heart is free ; — more distinct and marked when it is 
obstructed. 

Dr. Hope says the disease may be anticipated, if a person be sud- 
denly attacked with these three signs : namely, fever, violent action 
of the heart, and a murmur which did not exist before. 

This disease, like inflammation of the heart-case, is often produced 
by, and is intimately connected with, acute rheumatism. 

Chronic Inflammation of jjhe Heart's Lining. 

Physical Signs. — The impulse more perceptible and diffused than 
natural. 

The dull sound upon percussion covers a space of from four to 
eight square inches. 



254 HEART DISEASES. 



There is a sawing, rasping, or filing sound. This sound may cover 
one or both beats of the heart. Sometimes these unnatural sounds 
are double ; in which case, the first is 'caused by an obstruction to the 
natural flow of the blood forward ; the second, by the regurgitation 
or retrograde flow of the blood from some defect in the valve, — just 
as a pump valve may get out of order, and allow the water which 
has gone throug;h to flow back. 

Explanation. — A variety of organic changes occur in the valves, 
which give rise to the murmurs. Inflammation of the lining mem- 
brane of the heart, reaches the valves, causes puckering, thickening, 
vegetations, cartilaginous, bony, and fat-like degenations, which obstruct 
the blood in its onward flow, or prevent a closure of the valves, and 
allow it to flow back ; the former causing the first sound, the latter 
the second. If the unnatural noise be synchronous with the first beat 
of the heart, it implies disease in either set of the semilunar valves, 
or an impossibility of closing the auriculo-ventricular openings ; if it 
accompany the second beat, it signifies that either set of the semilu- 
nar valves may be open. 

A murmur attending the first beat of the heart, must be caused by 
a current of blood from a ventricle ; one attending a second sound, 
by a like necessity, is produced by a current into a ventricle. 

Treatment. — The same as that for pericarditis. It should be equally 
prompt and vigorous. It must not be forgotten that this disease leads 
to various organic diseases of the valves of a very grave character, 
and that such mischiefs can only be escaped by cutting the disease 
short in the very beginning. 

Disease of the Semilunar Valves. 

The inflammation of the lining of the heart makes sad work with 
the valves. The semilunars are subject to various changes in their 
structure. 

Physical Signs. — Obstructive Mumiur. — In disease of the semilu- 
nars, the first beat of the heart is accompanied or obscured either by 
the bellows murmur, or a sawing, rasping, or filing sound. The un- 
natural murmur, whatever it is, appears superficial or near. The 
second beat is natural. 

When the opening into the aorta is contracted, or in any way ob- 
structed by unhealthy growths, so that the blood is subjected to more 
than a natural degree of friction in passing, this sound will be heard. 
It is called obstructive^ because it arises from the obstruction of the 
blood in its forward course. 

Regurgitant Murmurs. — First beat of heart natural. Second beat 
accompanied or replaced by bellows murmur. There is sometimes a 
musical murmur. 

Explanation. — The regurgitant murmurs arise from the valves be- 
ing too small, or defective in some way, and allowing the blood to 
flow back through the orifice. 



HEART DISEASES. 255 



This murmur is loudest opposite the semilunar valves, and is more 
audible above these valves than heloiv them. 

When the aortic valves are contracted or shortened, and the open- 
ings are not guarded by them, so as to prevent the backward passage 
oi the blood, there is a double bellows murmur, — one when it is 
driven throughihe orifice, and another when xi flows back. 

Disease of the Mitral Valves, 

Physical Sig'ns. — Obstructive Murmur. — First beat of heart natu- 
ral. Second beat accompanied or replaced by bellows murmur. 

Re«:ur«'itrtnt Murmurs. — The first beat of the heart accompanied by 
a loud and rough bellows murmur. This sound is like sawing or 
filing. It is loudest above or below the nipple, between the fourth 
and seventh ribs. There is occasionally a musical murmur. The 
second beat of the heart is natural. Sometimes there is a purring 
tremor. 

General Symptoms of Valvular Disease. ^- Cough, in many cases 
with watery expectoration ; difficulty of breathing ; frightful dreams, 
and starting from sleep ; congestion of the lungs ; expectoration 
stained with dark and grumous blood ; swelling of the jugular veins ; 
a livid look of the face ; a feeling as if a cord were tied tight around 
the lower part of the chest ; general dropsy, of the legs and feet in 
particular ; passive hemorrhages from the mucous membranes ; en- 
gorgement of the liver and spleen ; congestion of the brain, with feel- 
ings of oppression. When the mitral valve is contracted, admitting 
regurgitation, the pulse is small, weak, irregular, and intermittent. 

These are the worst symptoms of an advanced stage. 

Explanations. — The examiner will distinguish the various sounds 
thus : 

The murmurs generated at the origin of the arteries, spread their 
sonorous currents upwards along these arteries. 

Those produced in the auricular orifices, will be conducted into the 
auricles, and propagated downwards towards the apex of the heart. 

Which Set of Valves. — To learn in which set of valves it origi- 
nates, therefore, find its seat, and trace its direction. 

Finding the murmur to be in the aortic orifice^ it is then known to 
be obstructive^ if the first sound is morbid^ and the second sound natu- 
ral ; and regurgitant^ if the first sound is natural^ and the second sound 
morbid. 

But if the murmur be in the mitral orifice, it is obstructive when the 
first beat of the heart is natural, and the second beat morbid ; and re- 
gurgitant, when the first beat is morbid, and the second beat natural. 

The Pitch or Key of a murmur depends on the distance of its seat 
from the ear of the listener ; — nearness giving a high, and distance a 
low key. Thus, a murmur seated in the orifice of the pulmonary 
artery, being nearer the surface, has a higher pitch than any other. 



256 HEART DISEASES. 



It is on about the same key with a whispered s, — sometimes a little 
lower, and depending somewhat on the sti'cngth of the current of 
blood, — a strong current elevating^ and a weak current depressing the 
tone. 

The mitral orifice is situated opposite the junction of the cartilage 
of the third rib with the left side of the breast bone. The aortic 
orifice is about half an inch to the right of this, and the same dis- 
tance lower. It is known by the key being lower, — about Hke a 
whispered r, which is the ordinary type of the sawing sound. 

Murmurs from pulmonic and aortic regurgitations^ are about two 
tones lower, in consequence of the currents of the blood being weaker. 
They are like whispering awe by inspiration ; and if the click of the 
valve be heard, the sound wiU be changed to paiu. 

Murmurs in the mitral valve, being more deeply seated, are about 
four tones lower, and are like a whispered v^ho. 

The tricuspid murmurs are higher than the mitral, because nearer 
the surface. 

The musical murmur has been compared to whistling, the cooing 
of a dove, and the mewing of a kitten. It generally results from re- 
gurgitation. 

The purring tremor is caused, generally, by regurgitation through 
the mitral valve. 

Other Symptoms Explained, — The difficulty of breathing, frightful 
dreams, congestion of the lungs, hemorrhages, engorgements, etc., 
mentioned above, all proceed from such valvular stifFenings, pucker- 
ings, ossifications, enlargements, and contractions, as occasion a decid- 
edly obstructed circulation. 

The small, weak, irregular, and interrupted pulse, is caused by con- 
traction of the mitral valve, Avhich occasions an insufficient or irregu- 
lar supply of blood to the ventricle, and causes the ventricle, by losing 
the resistance of the valve, to expend its force in a backward as well 
a forward direction, — thus sending but little blood into the arteries. 

Ti'eatment. — The tendency of valvular disease is to produce hyper- 
trophy and dilatation. The strong and ceaseless efforts of the ven- 
tricle to drive the blood through an orifice obstructed by valvular 
disease, will of course make the walls grow thick, which is hypertro- 
phy ; and at the same time, the accumulation of blood which cannot 
be driven forward fast enough, must tend to swell and enlarge the 
cavity, — which is dilatation. 

The great object of treatment, therefore, is to diminish the force 
and activity of the circulation, — to induce the heart to cease striving 
to do what cannot be done. 

To accomplish this, give sedatives (285) (94) (124). The hellebore 
and cohosh will be found particularly serviceable. 

The tincture of the American hellebore is about the best of all. 
Purgatives may be given according to the strength of the patient. 

When there is dropsy, and a scanty secretion of high-colored urine, 
diuretics, or medicines to increase the action of the kidneys, are very 
important. For this purpose, digitalis and acetate of potash (130) 



HEAKT DISEASES. '267 



are excellent. Should this not succeed in reducing the dropsy, an 
active purgative (31) may accompany it. 

Diaphoretics, or medicines which promote perspiration, are also 
useful. This opening of the skin, however, is generally brought 
about by the hellebore, etc. (124). 

The diet should be unstimulating, and yet should be sufficiently 
nourishing to prevent the patient from running too low. Animal 
food of the most digestible kind may be taken once a day ; though 
there are many cases requiring its entire rejection. 

The passions should be kept in the most perfect subjection, and 
flie life should be as tranquil as possible. Nothing- must be done in a 
hurry. 

Water in the He art -Case. — Hydropericardium. 

This disease is common as an attendant of general dropsy. 

PlivsiCill Si2;ns. — The impulse is undulatory, as if transmitted 
through a fluid, and it is not always of the same strength. 

The dulness extends upward in a conical form, in proportion to the 
amount of fluid ; — sometimes rising as high as the second rib. The 
impulse does not coincide w^ith the first beat of the heart. 

General Symptoms. — The patient has a sensation of 'the heart being 
in a floating state. The pulse is small, frequent, and intermittent. 

Expliliiiitioii. — The reason that the impulse does not occur at the 
same time with the first beat of the heart is, that the apex does not 
immediately strike the walls of the chest, — some time being required 
to push it up through the fluid. 

The beats of the heart sound more distant than natural in conse- 
quence of the organ being pushed away from the walls of the chest 
by the fluid. 

Palpitation. — Nervous Palpitation. — Anaemic Palpitation. 

There is a great deal of palpitation of the heart dependent on 
dyspepsia, hypochondria, hysterics, mental agitation, excessive study 
with deficient sleep, venereal excesses, and masturbation. 

Palpitations likewise occur from what is called ancemia, or a low 
and deficient state of the blood. 

Physical Signs. — The impulse is weak, fluttering, or tumultuous, 

— generally increased by trifles. 

The beats of the heart are increased in frequency, and sometimes 
marked by intermission. Now and then they are accompanied by a 
bellows murmur. There are musical murmurs in the jugular veins, 

— loudest a little above the collar bones. 

General Symptoms. — The complexion is generally pallid and blood- 
less ; the lips and the inside of the mouth partaking of the same pale- 

33 



258 HEART DISEASES. 



ness ; the pulse quick, small, weak, and jerking ; and during palpita- 
tion, it sometimes has a thrill. Slight causes produce breathlessness 
and faintness. A dislike of animal food, and a fondness for acids. 
The monthly discharge in females is deficient, and the whites take its 
place. Sometimes the menses are too profuse, lasting for several days, 
and consisting only of blood. In this state of things there is great 
feebleness both of mind and body, with rushing noises in the ears. 

Explanations. — The murmurs depend on a lack of blood. The con- 
ditions of their existence are, thinness of blood, a swift and spasmodic 
circulation, and particularly an unfilled condition of the blood-vessels. 
A brook is the more babbling in proportion as its water is more 
shallow. It is a law in physics, that heaviness of freight gives stead- 
iness of motion ; and lightness of freight gives unsteady motion. 
The fireman's hose trembles and vibrates when only half full of water. 
In like manner the blood-vessels are agitated when imperfectly filled. 

Treatment. — This is to be governed altogether by the cause of the 
trouble. If it be dyspepsia, hypochondria, hysterics, etc., these sev- 
eral diseases require their usual treatment ; when they are cured, the 
palpitation will stop. 

But when it is caused by a low state of the blood, then give for 
several weeks, iron, the compound mixture, and (316) (310). 

The food must likewise be nourishing, — tender meat, beef and 
mutton, with broths, etc. 

Gentle exercise will be required, and much exposure to a bracing, 
out-door air. 

Neuralgia of the Heart. — Angina Pectoris, 

This is a strictly nervous disease. It begins with a sensation of 
pain and constriction in the region of the heart. This pain is accom- 
panied with more or less pain and numbness in the left arm. In 
females it is not uncommon for it to be attended by great sensitive- 
ness and pain of the breasts. When the attack is violent, the pain 
in the heart is excruciating, and even terrific. There is attending this 
a feeling of great oppression in the chest, amounting, in the worst 
cases, to a sense of suffocation. The heart palpitates violently, the 
brain is oppressed, and fainting sometimes occurs. 

The disease is brought on, in nervous subjects, by over excitement 
of the heart. Walking up hill, against a strong wind, may bring it 
on. If walking at the time of the attack, the patient is compelled to 
stop, and stand still till the pain subsides. 

The disease is often connected with organic changes in the heart's 
structure, such as ossifications, and other alterations. 

Treatment, — When the complaint depends on organic disease of 
the heart, the treatment must be directed to the cure of these dis- 
eases. 

To relieve a severe attack, the patient should be instantly placed 
in a quiet position ; wind in the stomach, if present, should be ex- 



HEART DISEASES. 259 



pelled by peppermint or anise water, or ether, or (115), or some other 
aromatic. If there is acidity or sourness of the stomach, it must be 
corrected by a teaspoonful of soda in half a tumbler of water ; and 
if the stomach be full of undigested food, let the patient take a table- 
spoonful of ground mustard, stirred up with a teacupful of warm 
water. This will cause almost instant vomiting. 

These things being done, give some quieting, or antispasmodic 
medicines, as one sixth of a grain of morphine, or one of the following 
prescriptions: (285) (97) (135) (124). 

Great relief is often obtained by sending a current of magnetism 
through the region of the heart, by applying one pole of the machine 
in front, and the other upon the back. 

During the intervals, the general health is to be improved by a 
wholesome, nourishing diet, gentle, out-door exercise, and a careful 
control of all the passions. 

Polypus of the Heart. 

A PORTION of the fibrine sometimes separates from the blood in the 
heart and large vessels, and becoming more or less organized, forms 
polypuses, which fill the cavities to which they are attached, and seri- 
ously obstruct the circulation. 

Physical Signs. — When the pulsations of the heart, previously 
regular, become suddenly anomalous, confused, and obscure, so that 
they cannot be analyzed, we may suspect a polypus. 

General Symptoms. — A sudden and great aggravation of the bad 
breathing, without any visible cause, — the patient being in agony 
from a sense of impending suffocation, and tossing about from side 
to side, struggling for breath. The pulse small, weak, irregular, in- 
termittent, and unequal ; the surface and extremities cold ; the face, 
livid, — to which there is generally added nausea and vomiting. 

Treatment, — When the polypus is once formed, the case is hope- 
less. The treatment, therefore, can only be preventive. 

The chief things to be done are, to keep the patient in a state of 
entire tranquillity, and to bring the circulation to the surface, by keep- 
ing the skin warm, and excited by friction. This will call the blood 
away from the heart and great vessels, and lessen the chances of the 
polypus. 

Displacements of the Heart. 

The heart may be misplaced from birth. I have seen a case in 
which it lay upon the right side, and had always been in that posi- 
tion. Its action was natural. 

A variety of causes may tend to push it out of its place, as water 
in the cavity of the pleura. In such cases, it will return to its place 
when the water is drawn off or absorbed. 



DISEASES OP THE ABDOMINAL CAVITY. 



Fig. 94. 



Under the above head I shall consider most of the diseases which 
occur in the great cavity below the diaphragm, called the abdomen 
or belly. These affections are quite important, and make up a con- 
siderable part of the ills we suffer from disease. 

Before speaking of these diseases, however, I will call the reader's 
attention to a profile view of the 
relative position of the several or- 
gans lodged in this cavity. 

In Fig. 94, L is the liver, S the 
stomach, C the colon, R the rectum, 
B the bladder, P D the pancreas, 
and I the intestines. The double 
lines, folded back upon each other, 
and surrounding most of the or- 
gans, represent the peritoneum, a 
membrane which lines the great 
cavity of which I am speaking. 

It will be well, too, before pro- 
ceeding further, to make the reader 
acquainted with the names of cei- 
tain regions of the abdomen whicli 
he will find constantly spoken ot 
in medical books. I have not 
used these terms much in m\ 
book ; but it will be convenient 
to be acquainted with them. Phy 
sicians who are careless in their 
readings, are not always familial 
with their exact locality. 

In Fig. 95, the abdomen is di- 
vided into nine different regions 
by the drawing of two parallel 
lines up and down, 2, 2, and 3, 3, 
and two lines across, 4, 4, and 1, 1. 
three in the middle, and three below. 

In the upper row, 6 is the epigastrium, or epigastric region, in which 
are the left lobe of the liver, and a portion of the stomach ; 5, on the 



^] 


': '., ./ Y— 


\ .VM'. 


°*V^I ^ ' 


■/''::■ ^^ 


nK 


v^M- \ 


■ ■ ^ '-/rJ 


'v^/# ■',''" 


~%.y ^ '.If. k ■ ' 


, / 'l^- 


4::</|'' .'-'(' 




f:^' 


X'J"'"-^ 


_^\==^. /ji^jf ._' 




■ / /^^ ■ 




'■■ ■ '^ •■• ■■ ■■''■■■ 



This gives three regions above. 



DISEASES OF THE AEDOlVriXAL CAVITY. 



^;;i 



right 



Fig. 95. 






dde, is the rig'Jit hijpociiondriiim^ in which is the right lobe of the 
liver; and 5, on the left side, is the hft 
hypochondrium^ which contains the spleen, 
and a portion of the stomach and liver. 

In the middle row, 7 is the umbilical 
region, which contains the small intestines. 
On the right side, 8 is the rigiit lumbar re- 
g'ion, which holds the right kidney and Uie 
It-^ ascending colon ; and 8, on the le£t, is the 
left lumbar region, which contains the left 
kidney and the descending colon. 

In the lower row, 9 is the hypogastrium, 
or hypogastric region, which contains a por- 
tion of the small intestines and bladder. 
On the right, 10 is the right iliac fassa, 
containing the caecum or caput coli; and 10, 
on the left, is the left iliac fassa, contain- 
ing the sigmoid flexure. 

And now I may as well present, in 

Fig. 96, a front view of no 96. 

many of the organs both 

in the chest and abdo- 
men : 1, 1, 1, 1, are the 

muscles of the chest ; 2, 

2, 2, 2, the ribs ; 3, 3, 3, 

the upper, middle, and 

lower lobes of the right 

lung; 4, 4, the lobes of 

the left lung; 5, the right 

ventricle of the heart ; 6, 

the left ventricle ; 7, the 

right auricle of the heart; 

8, the left auricle ; 9, the 

pulmonary artery ; 10, 

the aorta ; 11, the vena 

cava descendens ; 12, the 

windpipe ; 13, oesopha- 
gus ; 14, 14, 14, 14, the 

pleura ; 15, 15, 15, the 

diaphragm ; 16, 16, the 

right and left lobes of 

the liver; 17, the gall 

bladder ; 18, stomach ; 

26, the spleen; 19, 19, 

the duodenum ; 20, the 

ascending colon ; 21, the 

transverse colon ; 25, the 

descending colon ; 22, 22, 

22, 22, the small intes- 
tines ; 23, 23, the walls of the belly turned down ; 24, the thoracic 

duct, opening into the left subclavian vein (27). 




262 DISEASES or THE ABDOAONAL CAVITY. 



Acute Inflammation of the Liver. 

The liver is the largest gland in the body. (See Fig. 31.) It lies 
in the right side, and at the top of the great abdominal cavity, di- 
rectly under the midriff, and lapping upon the stomach. Fig. 94 
shows its relative position. Its office is to take the superabundant 
carbon out of the blood. This carbon it unites with other elements 
and forms bile, the peculiar bitter substance, which is poured into the 
upper bowel, and greatly aids digestion. 

The liver is liable to become inflamed from several causes, such 
as gravel stones, external violence, suppressed secretions, hot climates, 
inflammation of the duodenum, etc. 

Sjiuptoms. — These are sympathetic fever, with pain, and a sense 
of tension in the right side, inability to lie on the left side, difficulty 
of breathing, a dry cough, vomiting, and hiccup. 

The pain is acute and lancinating generally, though sometimes 
dull and tensive. When sharp, it is like the stitch of pleurisy, and it 
indicates that the peritoneum which covers the liver is inflamed. 
When dull, it is the body of the organ which is sufTering. When the 
convex surface of the liver is the seat of the disease, the pain is apt to 
run up to the right collar-bone, and to the top of the right shoulder. 
Breathing, coughing, and lying on the left side, increase the pain. 
A soreness is felt by pressing over the liver. The pulse is full, hard, 
and strong, the bowels are costive, and the stools are clay colored, 
owing to not being tinged with bile, — this having stopped flowing. 
The tongue is covered with a yellow, dark brown, or even black coat, 
and there is a bitter taste in the mouth. 

Explanation. — The bile, secreted by the liver, is poured into the 
upper bowel, and gives the brown or the yellow color to the contents 
of the bowels. When the liver is inflamed, it cannot work, — it se- 
cretes little or no bile, and the discharge from the bowels lose their 
color. The bile is slightly physical, and when it ceases to flow into 
the bowels, they become bound or costive. When the liver does not 
work, the bile has to be taken out of the blood by the kidneys, and 
the urine becomes of a deep yeUow color. Much of it goes out 
through the skin, too, which is likewise yellow, and the sweat be- 
comes so yellow as to stain the linen. 

Treatment, — Apply wet cups or leeches over the liver pretty freely. 

Purgatives will also need to be used pretty freely at first. Those 
which produce watery stools (31) (247) (34) will be of the greatest 
service. 

After the cups and purgatives have been thoroughly used, blisters 
will be useful, and it will be better to apply several in succession, 
rather than to keep the first one open. Or, in the milder cases, a 
mustard poultice may be applied over the whole side, and even along 
the spine. 

Frictions over the stomach and liver with the nitro-muriatic acid. 



DISEASES OF THE ABDOMINAL CAVITY. 263 

and a foot bath of the same, •will sometimes do well. The acid 
should be reduced with water to about the strength of sharp vinegar. 
AVater a little soured with this same acid makes an excellent drink 
for the patient. 

Perspiration should be induced by the spirit vapor bath, and kept 
up gently by the tincture of the American hellebore, from three to 
ten drops every hour. Or, the same thing may be done by prescrip- 
tion (126). 

When the urine is scanty and high colored, give some diuretic, as 
infusion of hair-cap moss, or cleavers, or marshmallow root, or pre- 
scriptions (130) (131). 

The diet should be rice-water, gruel, and toast-water. "While get- 
ting up, it may gradually be improved, and some light tonics (49) 
(dS) (64) be added to it. 

- Chronic Inflammation of the Liver. 

There are few chronic diseases for which the physician is more 
often consulted than this. In the warm climate of the South, in the 
bilious districts of the West, and indeed even in the Middle and 
Eastern States, it meets us continually, and demands our attention. 
That it is difficult to cure must be admitted ; but a constant famil- 
iarity with chronic diseases, for several years, has convinced me that 
it is generally curable. 

S}iiiptoiiis. — A sense of fulness and weight in the right side, with 
some enlargement, and shooting pains felt in the same region, partic- 
ularly when it is pressed, with pains in one or both shoulders, and 
under the shoulder blades ; uncomfortable sensations when lying on 
the left side ; yellowness of the skin, eyes, and urine ; bowels irregu- 
lar, loose, or costive ; appetite disturbed ; sometimes a dry, hacking 
cough ; shortness of breath ; tongue whitish, and brown or yellow 
tow^ards the root ; a bitter and bad taste in the morning. The urine 
deposits a sediment on standing. There is generally a low and des- 
ponding state of mind, with irritability and peevishness of temper. 

The skin is often covered with yellow spots, and with a branny 
substance. The various symptoms of dyspepsia are often present. 
The nervous system is generally much disturbed, and there is a dis- 
inclination to apply the mind. There is frequently a great dread of 
imagined evil, supposed to be impending. 

Treatment, — This does not require to be as active as that for the 
acute form of the disease. 

If there is much tenderness of the liver, begin with mustard poul- 
tices, and the compound pills of podophyllin, or the compound pills 
of leptandrin, or (36). 

I have abandoned the use of mercury in this disease, as in most 
others ; but if any prefer to use it, the blue pill (52) will be found the 
most useful form. 

The compound tar plaster placed over the liver, in bad cases, is 
often very serviceable. 



264 DISEASES OF THE ABDO.MIXAL CAVITY. 

• An alterative (138) (146) will be fqund useful. 

The daily alkaline sponge bath must on no account be omitted. 
Vigorous friction must follow it. Vigorous constitutions will bear 
the shower bath ; in such cases it may, occasionally, take the place of 
the sponge bath. 

'The diet must be simple, yet nourishing .and wholesome, — and 
embracing but a small amount of fat, — as this is composed largely 
of carbon, and the liver is unable to remove w^hat is already in the 
blood. 

Especially and above all, out-door exercise must be taken to the 
full amount of the strength, and the thoughts be occupied with cheer- 
ful subjects. Let the hot sun be avoided, and the summer exercise 
be taken in the cool hours of the day. 

The recovery from this, as from all other chronic diseases, must 
necessarily be slow. 

Acute Inflammation of the Spleen. — Splenitis. 

The spleen is in the upper part of the belly, on the left side, oppo- 
site the liver. It is subject to acute inflammation, which is known by 
a pain just under the short ribs on the left side, also by swelling, sore- 
ness to the touch, and by more or less fever. The pain often shoots 
up through the midriff and to the left shoulder. There is a short, dry 
cough ; a feeling of tightness about the heart ; a sickness at the stom- 
ach, and vomiting ; and a discharge frequently of black blood from 
the bowels. The urine is scanty, is passed with some difficulty, and 
is high colored. 

This disease appears most frequently in hot climates, and is often 
connected with intermittent fevers. 

Chronic Inflammation of the Spleen. 

This prevails most in fever and ague districts, and is a frequent 
result of chills and fever. It is generally very stubborn, often lasting 
many years. 

SjTiiptonis. — A feeling of weight, tightness, and sometimes pain in 
the left side, — the pain being increased by pressure, or an attempt to 
lie on the left side. The organ sometimes enlarges very much, so 
that it can be felt by the hand. This enlarged mass passes under the 
common name of " ague cake." There are sometimes numbness, 
weakness of the legs, difficulty of breathing, palpitation of the heart, 
inability to exercise much, obstinate constipation, vomiting of food, 
piles, dry skin, tongue coated white or red, low spirits, and occasion- 
ally dropsical affections. 

During the chill in fever and ague, the spleen becomes enormously 
loaded w^ith blood. Surfeited and stretched in this way again and 
again, it is not strange that the organ should become diseased. 

Treatment. — This should be about the same with the treatment for 
acute and chronic inflammation of the liver. 



DISEASES OF THE ABDOMINAL CAVITY. SG.j 

After the active symptoms of inflammation are subdued, the warm 
bath may be used once or twice a week. 

In the chronic form of the disease, counter-irritation with the com- 
pound tar plaster, with mustard poultices, croton oil, or tincture of 
iodine, will be particularly needed. 

Among medicines, muriate of ammonia (53) has a high reputation. 
To keep the bowels open, podophyllin, quinine, and nux vomica (46), 
have a line etiect. Iron may be given (73) when the patient is blood- 
less and pale. 

Jaundice. — Icterus. 

The jaundice is a very common disease, and to be known, needs 
only to be seen. 

Sjiiiptom.s. — The most prominent symptoms are, yellowness of the 
skin and .whites of the eyes, saffron-colored urine, and whitish or clay- 
colored stools. So full is the urine of bile, that a piece of white 
linen, dipped in it, receives a bright yellow tinge. 

Beside these leading symptoms, there are impaired appetite, a loath- 
ing of food, the sense of a load at the pit of the stomach, sourness of 
- stomach, sometimes sickness and vomiting, a bitter taste in the mouth, 
|| disinclination to luove about, sleepiness, a dull pain in the right side, 
;i which is increased by pressure. 

j The entire body of a person who has died of jaundice, including 

i bones, muscles, and membranes, are found to be full of bile, and col- 
I ored yellow. 

Explanntiou. — The bile flows into the upper bowel, a little below 
the stomach, through a duct or tube about as large as a goose-quill. 
This little tube or vessel receives the bile from a smaller tube, called 
the hepatic duct, and from another which goes to the gall-bladder, 
called the cystic duct. 

These little tubes sometimes get obstructed or plugged up by 
sticky, thickened, or hardened bile, or by gall-stones, formed in the 
liver, and the bile finding no outlet through its natural channels, is 
taken up by the absorbents, distributed over the system, and produces 
the yellowness we witness. When these ducts and the gall-bladder 
are filled and stretched by this thickened and hardened bile, they be- 
come tender and sore. Hence the sore feeling in the side when pres- 
sure is made. 

There is another explanation of the way in which the yellowness 
of jaundice is produced, and it matters not whether it, or the one just 
given, be adopted. It is this : The bile is formed by the blood, and 
not by the liver. The office of the liver is to draw or strain off the 
bile from the blood. And when this organ is inflamed, or gets slug- 
gish and will not work, the blood is not relieved of its yellow freight. 
The bile accumulates, and in attempting to escape through other 
channels, it lodges in the various tissues, particularly in the skin. 

Treatment. — If there be much inactivity of the liver, the treatment 
may begin with an emetic (1) (2) (4). 

34 



266 DISEASES OF THE ABDOMINAL CAVITY. 

An infusion of thoroughwort, drank freely every day, is a valuable 
remedy. The inner bark of the barberry steeped in cider, or this arti- 
cle compounded with others (286) (287) will be found excellent. 

The diet should be plain, wholesome, and nourishing, but com- 
posed mostly of vegetable articles, particularly green vegetables and 
berries when they are to be had. 

Cold water should be the principal drink ; or drink and medicine 
may be combined in the shape of five drops of muriatic acid, and 
three drops of nitric acid, dissolved in a tumbler of water slightly 
sweetened. This is generally a pleasant drink, and will assist very 
much in the cure. 

The warm bath once or twice a week, and the alkaline sponge bath 
every day, with smart friction, must not be omitted. 

When jaundice is caused by the passage of gall-stones through the 
bile duct, there is sometimes terrible pain and suffering, — the stone, 
occasionally, being as large as a nutmeg, and forcing its way through 
a quill-sized tube. So great is the distress that the patient sometimes 
rolls upon the floor in agony. To alleviate this pain, large doses of 
opium, laudanum, or morphine, are required. A large teaspoonful of 
bicarbonate of soda dissolved in a tumblerful of hot water is an ex- 
cellent remedy if drank at a single draught. It relieves the acidity 
of the stomach, and acts as a fomentation to the internal seat of the 
pain. Mustard poultices, or warm fomentations, over the seat of the 
pain, are required. The warm bath is excellent. 

The acid bath, made by mixing three parts of muriatic acid with 
two parts of nitric acid, and adding as much of this mixture to water 
as will make it about as sour as weak vinegar, is valuable in jaundice. 
Only a quart of water need be taken ; and the solution should be 
applied with a sponge. It is of the right strength, if it produce a 
slight tingling of the skin. 

Gall Stones. — Biliary Calculi. 

These are concretions, or hardening of bile into masses of all sizes 
from that of mere grains, to that of a nutmeg. Fig. 97 is a specimen 
of them. They are. found in the gall bladder, the cystic 
duct, the hepatic duct, and are sometimes precipitated Fi^y^. 
from the bile after it has passed into the bowels. In pass- 
ing through the ducts, if of considerable size, they produce 
intense pain, particularly if they are jagged upon their ^^^ y 
surface. M^L 

These stones, so called, are composed, chemically, Qf "■"■■' 
cholesterine, bile pigment, choleic acid, choleate of soda, mucus, earthy 
salts, and margarin and its compounds. A nucleus seems to be 
first formed, and then a gradual accumulation takes place upon its 
surface. 

Symptoms. — An almost constant uneasiness in the right hypochon- 
driac region, with spasms of pain, coming on suddenly, and lasting 
for a time with great severity, and then subsiding. The pain is caused 




DISEASES OF THE ABDOMINAL CAVITY. 267 

by a stone being suddenly forced into the duct and moving forward in 
ix\ and it subsides when the stone either stops, or gets through the duct. 
When the stone reaches the bowels, it passes off with the stools. 

The patient generally has a pale, sallow complexion, a small, feeble 
pulse, and often sutlers from nausea and vomiting, and from restless- 
ness and hurried breathing. 

Treatment. — To reduce the spasm, give Dover's powder in full 
doses, or chlorodine. Also, apply mustard over the right hypochon- 
drium and stomach, and follow it with hot fomentations with hops, 
or use wet cups. 

If the stomach is irritable, give the neutralizing mixture until it 
moves the bowels. A warm infusion of thoroughwort, given to the 
extent of producing vomiting, will sometimes do well, and lobelia 
enough with it to relax the duct may be useful. 

To relieve the acidity on which the formation of these stones so 
often depends, a neutralizing preparation (338) may be given for a 
long time, the diet, in the mean time, being well regulated. The 
sponge bath, with saleratus and water, should be taken daily, followed 
by brisk rubbing ; and free exercise in the open air should on no 
account be omitted. ^ 

Acute Inflammation of the Stomach. — Gastritis. 

This is a rare disease. It is generally induced by irritating and 
corrosive substances taken into the stomach. Poisons, as arsenic, 
aquafortis, corrosive sublimate, and the like, are the most common 
causes of it. Blows, sudden stoppage of sweat, and excessive use 
of ardent spirits, may also excite it. 

SjTliptoms. — It is marked by burning pain in the Stomach, thirst, 
restlessness, anxiety, constant vomiting, prostration of strength, a 
quick, hard, and small pulse, incessant retching, a sunken counte- 
nance, hiccough, cold hands and feet, and a damp skin. 

Treatment. — If the inflammation be excited by poison, the reme- 
dies named under antidotes for poisons must be first employed. 

The poison being neutralized or thrown off", the inflammatory con- 
dition must be combatted with the remedies usual for such states. 
Mustard poultices to the feet, along the spine, and particularly over 
the pit of the stomach, will be among the first things to be employed, 
and should be followed by hot fomentations of stramonium leaves or 
hops, — both the fomentations and the poultices to be repeated as oc- 
casion may require. Dry cupping over the region of the stomach is 
useful. 

Drinks, — Cold water, bread-water, rice-water, arrow-root gruel, in- 
fusion of slippery elm bark, and of marshmallow. These should be 
taken in very small quantities, — say a teaspoonful at a time, — about 
twenty drops of tincture of aconite root being added to half a tum- 
blerful. Lumps of ice may be held in the mouth, and occasionally 
swallowed. 



2G8 disi:as::.. o/ nir: Ani>n:.[\s\L cavity. 

Injections. — Einetics and ph\>ic are not proper, but injections 
(24b) (2oo), or simply soap suds, will be required. 

The remedies must be pursued until all tenderness has disappeared 
from lhe pit of the stomach. 

While the patient is recovering, great care must be taken not to 
overload the stomach with food. Arrow-root, sago, and milk are 
among the first articles to be allowed. After these, will come grad- 
ually beef-tea, chicken broih, soft-boiled (^gg^, and beef-steak, until the 
whole diet can be restored. 

Chronic InHammation of the Stomach. 

This is a much more common disease than the preceding; indeed 
it is very common. Though it does not put life in immediate danger, 
it perverts the feelings of the stomach, and causes many of the symp- 
toms of indigestion. Dyspepsia, however, is a different complaint, 
and not necessarily connected with inflammation. 

Symptoms. — There is generally pain in the stomach, which is in- 
creased by the presence of food, and by external pressure. The pain 
is sometimes felt only during digestion. The fermentation of the 
food in the stomach generates a gas, which is frequently belched up. 
This is what is meant in common language by having "wind in the 
stomach," and "belching wind."' The meals are frequently vomited 
up ; the appetite is fickle, sometimes voracious, and again nearly ab- 
sent ; the thirst is likewise variant ; the' tongue is white in the centre, 
and red at the sides and tip, — sometimes smooth and red all over, 
like a slice of raw beef The urine is scanty and high-colored. 

The disease is very liable, if badly managed, to lead to ulceration 
of the coats of the stomach, and thence to a fatal end ; for an ulcer 
may penetrate the walls of the stomach, and let its contents into the 
abdominal cavity, which would excite an immediately fatal inflamma- 
tion. 

Trentment. — If there be much tenderness, we may apply leeches 
over the stomach. With less tenderness, counter-irritation will an- 
swer, — as blisters, croton oil, mustard poultices, the compound tar 
plaster, or dry cups. 

The skin of the whole surface should receive special attention. 
The warm or the cold bath should be used often, according to the 
streuijTh of the patient. When the reaction is good, a cold compress 
bound upon the stomach every night, will do much to bring relief. 

The diet cannot be too carefully managed. While there is consid- 
erable tenderness, the nourishment must be of the most simple and 
uninitating kind, — consisting of little more than the most bland 
imtritive drinks ; and even these should be taken in small quantities 
at a time. Gum arable water, rice-water, barley-water, arrow-root 
gruel, tea, and toast without butter, will be amply sufficient to- keep 
soul and body together, and will, in two or three weeks, generally 
starve the enemy out of his quarters. After this, a more nourishing 
diet may gradually be resumed. 



DISEASES OF THE ABDOMINAL CAVITY. 269 



Indigestion.— Dyspepsia. 

DvspErsiA is a disease of civilization. Savages know nothing of 
ir. Ir is the costly price we pay for luxuries. All civilized nations 
siilVer from it, more or less, but none so much as the people of the 
United States. It is here, m the new world, that the disease has be- 
come domesticated, and we, as a people, who have threatened to 
monopolize its miseries. 

Few disorders indict upon their victims greater suffering; yet it is 
not particularly dangerous, and it is even doubtful whether it tends 
very much to shorten life, unless the length of life be judged to con- 
sist in the sum of happiness enjoyed, — in which case, few complaints 
shorten it more. 

Syiiiptoins. — These vary very much in different stages of the dis- 
ease, and. in different persons. In gL'neral the complaint begins with 
a sense of fulness, tightness, and weight in the stomach, sooner or 
later, after meals, and a changeable, diminished, or lost appetite. 
Occasionally, the appetite is craving, and when, in obedience to its 
promptings, a large meal is taken, there is pain in the stomach, with 
general distress and nervousness, and sometimes vomiting. Flatu- 
lency and acidity arc common, with sour and offensive belching of 
wind; and very often there is a water-brash, or vomiting of a clear, 
glairy liuid when the stomach is empty. Diziness is a prominent 
symptom. There is a great deal of what patients call an "all-gone" 
feeling at the pit of the stomach, — a weakness so great at that par- 
ticular spot, that it is very hard to sit up straight. There is a bad 
taste in the mouth ; the tongue is covered with a whitish fur ; there 
is headache, heartburn, palpitation at times, high-colored urijie, and 
tenderness, now and then, at the pit of the stomach. The bowels are 
generally irregular, sometimes very costive, at other times loose, when 
portions of food are passed off undigested. 

XervoiiS Complication. — Such are the symptoms in a case of sim- 
ple disorder of the stomach, when no other part of the system is 
materially involved. This is mdlg-estion, well-mu,vked, and distressing 
enough ; but it is only a part of what is understood by a case of 
modern dyspepsia. In this^ either the indigestion, in its course, dis- 
turbs and involves the nervous system, or the nerves become them- 
selves disordered, and produce the indigestion. Sometimes one hap- 
pens, sometimes the other, it matters not which ; both are present, — 
the affection of the stomach and of the nerves, in a case of thorough 
dyspepsia. To make out a full case, in its tormenting completeness, we 
must add to the above symptoms, great depression of spirits, amount- 
ing at times to complete hopelessness and despondency ; a dread and 
fear of some impending evil; a lack of interest in passing events; un- 
willingness to see company or to move about; an irritable and fretful 
temper ; a desire to talk of one's troubles, and nothing else ; a sallow, 
haggard, sunken, and sometimes wild expression of countenance ; a 
dry, wrinkled, and harsh skin, with unrefreshing sleep, disturbed by 



270 DISEASES OF THE ABDOMINAL CAVITY. 

all sorts of annoyances and difficulties, such as shipwrecks, falls down 
precipices, and nightmare. 

The man who has all these symptoms, or any "considerable portion 
of them, has dyspepsia^ and is about as miserable as if all the sorrows 
of life were electrical currents, and were running through him contin- 
ually. *r 

Causes of Dyspepsia. — To healthy digestion, three conditions are 
especially necessary, — that the food should be well chewed and 
mixed with saliva before it is swallowed ; that the stomach should 
pour out and mix with it the right amount of healthy gastric juice ; 
and that it should be well churned while in the stomach. 

It is well known that the first of these conditions, a thorough chew- 
ing of food is rare in this country. , We eat too fast ; we do not mas- 
ticate our food ; we bolt it whole. 

This is the first cause of dyspepsia, and it is the fruitful mother of 
causes. It furnishes the occasion for eating too much ; for when the 
food is swallowed with such rapidity, the stomach is taken by sur- 
prise, as it were ; it cannot secrete gastric juice fast enough to be 
diffused through the fast-growing mass ; and the appetite does not 
decline until a great deal too much is taken. The coats of the stom- 
ach, being stretched unnaturally, do not pour out the gastric juice at 
the right time, or as much of it as is wanted, and what there is, is 
altered in quality. 

Moreover, the stomach being overburdened, cannot turn over and 
churn its contents properly. 

To fast eating, we may add, high-seasoned dishes, too stimulating 
for the stomach; eating between meals, and at unseasonable hours, — 
particularly at bed-time ; excessive use of strong drinks and tobacco ; 
habitually sitting up late at night ; inactive habits of body ; and ex- 
cessive use of the mind. 

No causes of dyspepsia are more active than those which disturb 
and fret the mind. It is surprising how suddenly any mental agita- 
tion will put an end to the appetite, and suspend digestion. And 
when these mental disturbances are protracted, when care becomes a 
daily and hourly companion, dyspepsia is almost sure to show itself. 
Considering the numerous causes of unpleasant mental excitement 
which we have in the politics, the business, the ambition, the family 
jars, etc., of this country, it is a wonder that dyspepsia is not even more 
prevalent. It is hard for the sensitive to escape. 

Urinary Deposits. — Before speaking of the treatment of dyspepsia, 
it will be proper to take notice of certain deposits in the urine, to 
which persons suffering from this complaint are liable, and the dis- 
covery of which, will, in many cases, indicate the treatment. 

Many dyspeptics have acid urine, which is loaded with crystals of 
oxalate of lime. These persons are much depressed in spirit, and 
look upon the dark side of everything. They are painfully disturbed 
by small annoyances, are irritable in temper, incapable of exerting 
themselves, look with dread upon the future, and generally have the 
dark and dingy look of the face, which indicates functional derange- 
ment of the liver. 



DISExVSES OF THE ABDOMINAL CAVITY. 



271 



The most of these crystals are octahedral in form, and in the field 
of a good microscope, are beautiful objects for inspection. (Figs. 98 
and 99.) To obtain them, take a portion of urine passed in the 
morning (nrina sang'tdnis), and let it stand till a deposit takes place. 
Pour oil" the upper portion of the urine ; put a part of the remainder 
in a watch glass, and gently heat it over a lamp. The heat will cause 
a deposit of the crystals. 



Fig. 9S 



Fig. 99. 



Fig. 100. 




The oxalate of lime is frequently found in urine, having the form 
of dumb-bells. When examined by polarized light, they appear beau- 
tifully colored and striated. (Fig. 100.) 

The urate of ammonia, and uric acid gravel, are likewise found in 
large quantities, in the urine of many dyspeptics. Some are exhausted 
by them, and reduced almost to skeletons, and to a wretched state of 
health, — having boils, eruptions, etc. 

To find the urates, put a little of the urine containing the deposit 
in a test tube, and warm it gently over a lamp. If the deposit readily 
dissolve^ it is probably urate of ammonia (Figs. 101 and 102), and may 
then be examined under the microscope, to make the matter sure. 



Fig. 101. 



Fig. 102. 





To find uric or lithic acid, let morning urine stand until a solid 
deposit has sunk to the bottom ; then pour off the liquid, and place 
some of the solid portion upon a glass, and examine it with a micro- 
scope, and if this acid be present, its peculiar crystaline forms 
(Fig. 103) will be discovered, either alone, or mixed with urate of 
ammonia. 

In those cases in which there is a great prostration of the nervous 



■272 



DliSEASES OF THE ABDOMINAL CAVITY. 



system, with a loss of sexual power, bad feelings in the head, perhaps 
pain and weakness across the loins, and a tendency to consumption, 
j>j(j 103. "^6 ^^^y suspect the presence of the triple 

phosphates in the urine. Phosphorus is 
one of the elements of the brain and 
nerves, and when there is a constant drain 
of this element through the kidneys, the. 
nervous system is gradually exhausted. 
To find the triple phosphates, put some 
morning urine in a glass vessel, and let it 
stand till a sediment has gone to the bot- 
tom. Put some of the sediment in a test 
tube, and warm it gently over a lamp. 
If the warmth do 7iot dissolve the deposit, 
add to it a little acetic acid ; if the de- 
posit dissolve in the acetic acid, it proba- 
bly consists of earthy phosphates. This is 
then to be examined under the micro- 
scope to ascertain whether it is the phos- 
phate of lime, the triple phosphate, or a mixture of both. 




Fig. 104. 



Fig. 105. 



Fig. 106. 






Fig. 107. 



Fig. 104 shows us the prismatic crystals of the triple phosphate. 
In a few rare cases, tWese are penniform (Fig. 105). Fig. 106 gives 
us another specimen' of the crystals of the 
triple phosphates, as they appear under the 
microscope, mixed with amorphous particles 
of phosphate of lime. If an excess of am- 
monia be added to the urine, the crystals 
become star-like, and foliaceous, as in Fig. 
107. 



Treatjiieiit of Bv.spepsii). — As there are 
few complaints which distress the patient 
more than dyspepsia, so there are few which 
give the physician more trouble. Generally 
our art has failed upon it because too much 
has been required of us. We have not merely been asked to cure 
the disease, but to do it while the patient continues the indulgence of 
his appetite, or his excessive application to business or study. It has 




DISEASES OF THE ABDOMINAL CAVITY. 273 

been expected of us, that with medicine we should contravene the 
laws of nature, and restore health while the causes of disease are in 
full activity. 

This complaint is often brought on by not keeping the bowels 
open. To cure it, therefore, one of the first things to be done is to 
remove costiveness and regulate the bowels. 

j One of the very best articles I know of to remove constipation is 
/Mettauer's Aperient. I have placed it in the department of Phar- 
f macy ; it ought to be in the United States Dispensatory. Taken 
immediately after meals, in doses of a teaspoonful, it corrects acidity 
of the stomach, it gently opens the bowels, and when its action is 
over, will be found to liave diminished the costiveness, rather than in- 
creased it, as most kinds of physic do. It is excellent in the bilious 
forms of dyspepsia, — acl4ng finely upon the liver, — particularly if 
a few drops of aqua regia in water be taken before meals, — the ape- 
rient being taken after. 

If piles exist, this mixture will be objectionable on account of the 
I aloes, and the fluid neutralizing extract may take its place. Sweet 
\ tincture of rhubarb and soda (37) is sometimes preferable to the ape- 
rient. 

Several other preparations (38) (289) (39) (290) will be found use- 
ful to remove costiveness and debility of the stomach. 

For acidity, beside the remedies already mentioned, prepared char- 
coal may be used, in teaspoonful doses, or carbonate of magnesia, or 
I fluid magnesia, or trisnitrate of bismuth. A good remedy is pulver- 
/ized guaiacum, rhubarb, and prepared charcoal, equal parts, in tea- 
/ spoonful doses ; also (28) (37) (38) (42). If crystals of oxalate of 
; lime be found in the urine, give a few drops of aqua regia, in water, 
three times a day. 

IIvG^ieiiic Treatment. — The diet must be managed with great pru- 
dence. Food must be taken in such quantities only as the stomach 
can digest, however small that quantity may be ; and it must be taken 
slowly, and well chewed. No article should be touched, or thought 
of, which disagrees with the stomach. Costiveness may frequently 
be entirely removed by eating no bread except that made from un- 
bolted wheat flour, commonly called Graham bread, or by making 
one of the three daily meals of boiled cracked wheat, with milk or 
molasses. If the triple phosphates be found in the urine, there is a 
special reason why the unbolted flour, or the cracked wheat should 
be used. The wheat grain abounds in phosphorus, the largest por- 
tion of which is in the bran, and this is much needed when the kid- 
neys are robbing the brain of its phosphoric element. 

\ot too iiiucli Brain-work. — It is important that the brain and 
nervous system should be relieved of the burden of too much work, 
and that the thoughts should be turned into the most agreeable chan- 
nels. If the patient would get well, the disinclination to move about, 
and see company must be resisted. In many cases, dyspeptics are 
like sea-sick persons, — feeling as though they would rather go over- 
board than move. In such instances, friends must not be harsh with 

35 



274 DISEASES OF THE ABDOMINAL CAVITY. 

them, and frown upon their listlessness as if it were a fault ; but 
rather treat them affectionately, and beguile them out by all sorts of 
pleasing enticements. Exercise must be had, every day, and be con- 
nected, if possible, with an object, so that it may be performed cheer- 
fully. It is important to oig-age the mind in the exercise ; and for this 
purpose, some contested game is very useful, as playing at billiards, 
rolling nine-pins, pitching quoits, or, where the strength will permit, 
playing ball. 



/ 



Cheerfulness. — Nothing does more to drive away dyspepsia than a 
cheerful, lively, and even mirthfid state of mind. All the nervous in- 
fluences sent from the brain to the stomach should be of the most 
agreeable kind. Some people think it vulgar to laugh. Let such 
stand with long faces in life's shadows, if i?hey choose. As a general 
rule, the best men and women laugh the most. Good, round, hearty, 
side-shaking laughter, is health for everybody ; for the dyspeptic, it is 
life. ^'"^^^--^ 

Dyspeptics who have a taste for it, and can endure the expense, 
should travel. A voyage to Europe, and a year spent in seeing the 
wonders of the old world, will generally cure the most stubborn case 
of indigestion. This, however, depends upon circumstances. For 
those having the finer organizations and the higher natures, extensive 
travelling is sometimes indispensable. The narrow circle* of thoughts, 
associations, and things, in their own neighborhood, do not fill the 
compass of their wants ; their many-sided faculties need to be drawn 
on by the large variety to be found only in travel. Their large and 
impressible natures want to be filled full in order to drive out disease, 
and it takes a world, or a considerable part of it, to fill them. The 
dyspepsia of such natures is not comprehended by the multitude, and 
even physicians are often amazed that their narrow prescriptions do 
not reach it. 



Heartburn. — Cardialgia. 

This is a gna\\mig and burning pain in the stomach, attended by 
disturbed appetite. It is generally caused by great acidity of the 
stomach, and is a symptom of dyspepsia, and often afflicts pregnant 
women. Whenever too much food is taken, it is liable to ferment, 
and become extremely sour, — causing heartburn. In such cases, 
vomiting often occurs ; and what is thrown up, is sour, and some- 
times bitter. 

Treatment. — Immediate temporary relief may be obtained by swal- 
lowing a teaspooiiful of soda, magnesia, or chalk, in a tumbler of cold 
or warm water. Fluid magnesia, or lime water, will answer the 
same purpose. If there is wind in the stomach, as well as acidity, a 
teaspoonful of the aromatic spirit of ammonia, or (135), will often 
still the uneasiness in a moment. . 

To cure the complaint, the stomach must be strengthened by the 
remedies directed for dyspepsia. 



DISEASES OF THE ABDOMINAL CAVITY. 275 

Spasm or Cramp in the Stomsich.— Gastrodpiia. 

Though generally of shorter duration, this is more violent than 
heartburn. It is attended by a sense of fulness, by anxiety, and by 
great restlessness. In females, hysterical symptoms are often coupled 
with it. Great quantities of air or gas are generally expelled, and the 
j>ain shoots through to the back and shoulders. 

Treatment. — A strong purgative injection (248) will often bring 
immediate relief. The sweet tincture of rhubarb and soda (37), with 
a few drops of tincture of cayenne mixed with it, will often bring 
speedy relief. So will a mustard poultice laid upon the stomach. 
The mustard poultice is a remedy of great excellence, in many cases. 
It deserves to be called the poor man's friend. 

Water Brash. — Pyrosis, 

This consists in a discharge from the stomach, generally in the 
morning, of a thin, glairy, watery fluid, sometimes insipid, at other 
times, sweetish, and at still others, sour. A burning heat or pain in 
the stomach attends, and seems to be the immediate cause of the 
discharge. The discharge appears to be the natural mucus of the 
stomach, which is poured out in large quantities in consequence of a 
kind of catarrh of its mucous lining. The amount thrown up varies 
from a spoonful to a pint or more. 

The complaint is caused by a poor innutritions diet, or by whatever 
causes the 'blood to become thin and watery. 

Treatment, — Ten or fifteen drops of water of ammonia, in half a 
tumbler of water, will quiet the distress, and check the discharge. 
The most effectual remedy I am acquainted with for breaking up the 
discharge, is the trisnitrate of bismuth, taken at meal times, in from 
twenty to thirty-grain doses, three times a day. The compound pow- 
der of kino is a valuable remedy. The compound tincture of senna 
and the tincture of balsam of tolu, in equal parts, and administered 
in tablespoonful doses, are sometimes useful. The tincture of nux 
vomica is a good remedy. 

To restore the blood, some of the various preparations of iron (74) 
(80) (73) (316) will be required. 

The diet should consist of easily-digested, nutritious food, — as 
soups, broths, fresh meat, potatoes, and unbolted wheat bread. 

Vomiting. 

This occurs under a great variety of circumstances. It may be 
induced by acidity of the stomach, by irritability of the stomach, by 
distress of mind, by injury of the brain, by offensive odors, and by all 
organic diseases of the stomach. 

Treatment. — Generally, it is cured by treating the disease which 
induces it. But in many cases, it persists very obstinately, and may 
become the chief thing to be attended to. In such cases, it may re- 
quire a sixth or quarter of a grain of morphia to check it. But gen- 



276 DISEASES OF THE ABDOMINAL CAVITY. 

! erally some aromatic, as ginger, spearmint, peppermint, or spice tea, 

will put an end to it. Some cordial or stimulant, as brandy, cham- 

' pagne, tincture of ginger, paregoric, elixir solutis, or cherry brandy, 

! will answer well. Strong coffee, without sugar or milk, will, in some 

j cases, act like a charm. If it is dependent on acidity, the remedies 

I are given under "dyspepsia." If caused by irritability of stomach, 

' a pill of extract of belladonna and ipecac (339) will do well. 

j While vomiting, the patient should lie still in bed, and in bad caches, 

I a mustard poultice should be placed upon the stomach. 

I The vomiting of children may sometimes be stopped by wetting a 

I piece of cloth with laudanum, and laying it upon the pit of the stomach. 

|j Seasickness. 

h This is the great terror of persons, who, for the first time, cross the 

ocean. It is said that dark complexioned persons suffer more from it 
than others. 

If it cannot be entirely prevented, it may be mitigated by lying flat 
upon the back. To lie on deck, in the open air, is much better than 
lying in the close air of the cabin, or state room. A wineglass of 
brandy, or from ten to forty drops of laudanum will relieve the sick- 
ness very much. For a child, it is sometimes sufficient to wet a cloth 
I with laudanum, and lay -it upon the pit of the stomach. Morphine 
I is sometimes even better than laudanum. Creosote, one drop at a 
dose, made into a pill, is excellent. Ten drops of hartshorn, in half a 
tumbler of water, is good for some. But the best known remedy is 
chloroform, taken in doses of from forty to eighty drops, suspended 
in water by means of a little gum arable. 

Milk Sickness. 

\\ This disease prevails in the West, chiefly in the neighborhood of 

I level, heavily-timbered, rather wet oak land. 

I The cattle, horses, and sheep, which range in these lands, are fre- 

j quently attacked by a disease which the people call the trembles. It 
is supposed to be produced by eating some plant growing upon those 
lands, as cattle which feed in the neighboring regions are free from 
it until they find their way into these low grounds. It has been sug- 
gested that the offending plant may be the poison ivy {rhiis toxicoden- 
dron). Be this as it may, the calves, soon after sucking cows which 
have run in these grounds, are seized with trembling, and frequently 
die of the disease. Dogs which lap the milk, are affected in a similar 
manner. Children drinking it, leave the table and vomit. Upon 
grown persons the eflects are more severe, but not so sudden. The 
eating of the beef, mutton, or veal, of affected animals, brings on the 
same disease. 

Symptoms. — The disease sets in with sickness at the stomach, 
which is preceded by general debility, more particularly of the legs. 
There is nausea, vomiting, and the breath is so offensive and peculiar 
that those acquainted with the complaint immediately recognize it 
from this smell. 



DISEASES OF THE ABDOMINAL CAVITY. 277 

These existing for weeks, constitute, in some cases, the whole of 
the symptoms. In other cases they are more severe, being attended 
by chills and flushes, great oppression about the heart, anxiety, deep 
breathing, heat in the stomach compared to fire and boiling water, 
violent retching and vomiting, alarming beatings of the heart, and 
tlirobbings of the large vessels, and cold extremities, — producing, all 
together, extreme distress. 

In most cases, the vomiting returns every hour or two, attended by 
great burning at the pit of the stomach, the substance thrown up 
having a peculiar bluish-green color, and a sour smell. As soon as 
this discharge takes place, the patient falls back upon the pillow, and 
lies easv until another turn comes round. The tongue is covered 
with a whitish coat, the bowels are obstinately costive, and the pulse 
is small and quick. 

Treatment. — It is believed that the neutralizing mixture, given in 
tablespoonfal doses every time the nausea and burning sensation are 
felt, is the most effectual remedy yet used. It relieves the acidity, 
and seems well adapted to allay the irritation. Some antibilious 
phvsic (40) to move the bowels should also be given. 

Beside these remedies, a mustard poultice shonld be put upon the 
stomach, and hot bricks to the feet, and the patient be kept still for 
some hours. The diet should be very mild, only toast water, rice 
water, or thin gruel. 

Acute Inflammation of the Peritoneum. — Peritonitis. 

This disease affects the extensive membrane which lines the whole 
inside of the belly, an extension of which forms the omentum or 
apron. It is an inflammation to which women are much exposed 
after confinement, and is known, in such cases, as child-bed fever. It 
is common among men, also, and is a grave disease. 

Symptoms. — Like other forms of fever and inflammation, it is pre- 
ceded by chills, with increased heat of surface, thirst, full, strong, and 
frequent pulse, flushed face, and red eyes, dry tongue with red edges, 
dry skin, restlessness, short quick breathing, nausea and vomiting. 

The pain is increased by the patient sitting or standing up, — the 
bowels being thus pressed against the inflamed membrane. Lying 
upon either side is painful for the same reason. To lie flat upon the 
back, with the feet drawn up, is the only endurable position. The 
patient lies still., for all movements give pain. 

The pain in this disease is generally sharp, cutting, and pricking, 
but is not always equally intense. It is aggravated by the passage of 
wind along the bowel, by w^hich the inflamed membrane is slightly 
stretched. 

When the disease is advancing towards a fatal termination, the belly 
becomes greatly swollen and tense, — having to the hand a peculiarly 
tight, drum-head feeling ; the pulse is rapicl and feeble ; the counte- 
nance is full of anxiety, and is pinched and ghastly ; and a cold sweat 
breaks out. 



278 ])ISEASES OF THE ABDOI^IIXAL CAVITY. 

Treatiiieilt. — Small doses of antimony, lobelia, or ipecac, to pro- 
duce nausea, and a moisture upon the skin, is generally among the 
first things given. The tincture of veratrum viride, in five to ten- 
drop doses, repeated every hour, will accomplish the same thing more 
effectually than any other known article. For such purposes, I give 
it the first place among medicines. A large poultice of white bread, 
rye meal, or flax-seed, may be spread over the belly ; or cloths wet 
with cold water, will be still better, if the patient be full-blooded, and 
naturally strong. The bowels should be moved at once by some 
active physic, as butternut, salts, magnesia, castor oil, or cream of 
tartar (20) (17) (18) (27), or by podophyllin, etc. (40) (41) (31). 

The drinks should be lemonade, soda water, tamarind water, current 
jelly dissolved in water, and preparations (298) and (299). Indian 
meal gruel, toast-water, barley gruel, and the like, are the only allow- 
able diet. 

• Chronic Inflammation of the Peritoneum. 

When the acute inflammation of the peritoneal membrane is not 
successfully treated, it may run on for a time, and then subside into a 
lower grade of inflammation, called chronic^ and in this state remain 
for an indefinite time. But it often arises independently of the acute 
disease, and attacks persons of both sexes, and of all classes and ages. 
Scrofulous children have it, and, wasting away under it to mere skel- 
etons, are said to have consumption of the bowels. 

Symptoms, — These are sometimes very obscure, and the advances 
of the disease stealthy. At first, there may be only a little soreness 
of the belly, so slight as not to be noticed except after hard work, or 
upon some wrenching motion. Generally, there is a sense of fulness 
and tension of the belly, although it may not be increased in size. 
After a time, it enlarges a little, and its tension or tightness increases, 
especially towards evening. By pressing carefully with the hand, a 
deep-feeling tension may be detected, giving to the hand a sensa- 
tion as of a tight bandage underneath, with the skin and integu- 
ments sliding loosely over it. If water has been poured out into the 
abdominal cavity, its fluctuation may frequently be detected by press- 
ing upon one side of the belly with the palm of one hand, and strik- 
ing the other side with the ends of the fingers. 

As the disease goes on, the features become sharp and contracted, 
and the countenance grows pale and sallow. Costiveness comes on, 
sometimes chills and fever, with debility, loss of flesh, cough, difficult 
breathing, hectic, and swelling of the legs. 

Treatment. — Costveness, if present, may be relieved by Mettauer's 
aperient, or the neutralizing mixture, assisted by coarse bread, and 
boiled cracked wheat. 

Daily bathing is specially necessary, particularly the alkaline sponge 
bath, with vigorous friction over the bowels. The warm bath once 
or twice a week, will be useful. In some cases, the wet towel laid 



upon the bowels over night, and well covered by flannels, will afford 
relief; or the compound tar plaster may occasionally be used. 

If there be dropsy of the belly, iodide of potassium (138) should 
be taken freely, and the skin made sore over the inflamed part, by 
tincture of iodine, well rubbed in, once a day. 

If the patient be pale and bloodless, give iron, quinine, etc. (74) 
(75), and let the diet be nourishing; and if nervous symptoms be 
connected with the debility and paleness, add some nerve tonic (93) 
(81) (316). 

Acute Inflammation of the Bowels. — Enteritis. 

By inflammation of the bowels is generally understood an inflamed 
condition of the mucous membrane which lines them; but this, most 
commonly, is only a part of the disease ; it involves, more or less, 
beside this mucous lining, the whole substance of the bowel. 

Sjiiiptoms. — The disease begins\vith a chill, and with uneasiness 
and slight griping pains, which increase in severity until they are in- 
tense and burning. Pressure aggravates the pain, which is most 
intense about the navel, but extends more or less over the whole 
bowels. 

From the beginning there is sickness at the stomach, and some- 
times vomiting ; there is loss of strength, costiveness, great anxiety, 
thirst, heat and fever, dry, furred, and red tongue, and but little urine, 
with pain in passing it. The matters passed from the bowels are 
dark and fetid ; and the whole belly is tender and sore to the touch. 
The pulse is quick, hard, and small. 

The stomach will be but little affected, comparatively, when the 
disease is at some distance from it in the lower portion of the bowels. 
Indeed, the nearness of the inflammation to the stomach, or its re- 
moteness from it, may be judged pretty correctly by the degree of 
disturbance in that organ. The length of time after drink and medi- 
cines are swallowed, before they are vomited up, is a pretty good 
measure, likewise, of the distance of the disease from the stomach. 

How to Discriminate. — This disease is liable to be confounded 
with colic, and with inflammation of the peritoneum. It is important 
to distinguish it from colic, particularly, for the treatment for that 
would aggravate this. In this disease, the pain is increased by pres- 
sure ; in colic, it is not, but is rather relieved. In enteritis, the pain 
remits, but never ceases wholly, as it does in colic. In enteritis, 
the knees are drawn up, and the breathing is short ; in colic, it some- 
times gives relief to stretch the feet down, and the breathing is not 
altered. 

To distinguish it from inflammation of the peritoneum, take notice 
that diarrhoea is much more common than in this latter complaint, 
while the pulse is not as quick, nor the pain as severe. 

Treatment, — This should be very much the same as that recom- 
mended for inflammation of the peritoneum. Perhaps in both dis- 



280 DISEASES OF THE ABDOMINAL CAVITY. 

eases, it might be well to begin with covering the belly all over with 
leeches. As for taking blood from the arm, in large quantities, as 
recommended in most of the books, I cannot think it necessary. 

The tincture of veratrum viride, in full doses, so as to keep up a 
free perspiration, cold compresses, mustard poultices, hot fomentations, 
poultices, blisters, soothing and quieting injections, and demulcent 
drinks, as slippery elm, marshmallow, flax-seed, etc., if judiciously ap- 
plied, will do about all that we have it in our power to accomplish ; 
and under such treatment, the patient will recover faster, and get up 
better, than when blood is freely drawn. 

In this disease it is well to inquire if the patient has a hernia, for if 
so, it is liable to become strangulated without his knowledge. A 
strangulation of the gut may be the cause of the disease. When this 
happens, the complaint is very unmanageable. The bowel may pos- 
sibly, in such case, be disentangled by applying a large dry cup ; or, 
what is better, a number of small ones ; but the tenderness of the 
belly makes the use of this remedy ditHcult. 

Chronic Inflammation of the Bowels. 

Like other chronic inflammations, this may follow the acute form, 
but it also results from various other causes, as unripe fruit, taking 
cold, drastic physic, and improper treatment of other diseases. 

SjTiiptoms. — Red end and borders of the tongue, dull pain in belly, 
increased by pressure and rough motion, abdomen either swelled or 
fiat, skin dry and husky, feet and hands cold, small frequent pulse, 
thirst, loss of flesh, low spirits, urine scanty and high-colored, and 
dirty, slimy discharges from the bowels, from one to four times a 
day. 

Treatment. — To begin with, blisters, or croton oil, or mustard poul- 
tices, or dry cups, if the tenderness is not great, or leeches if it is. 

If the bowels are hot and feverish, bind a cold compress upon the 
belly over night, — covering it well with flannel. The warm bath 
should be used twice a week. 

The diet must be of the most simple, unirritating kind, — beginning 
with a solution of gum arable, rice-water, barley water, arrow-root or 
sago gruel, and gradually rising, as the symptoms improve, to beef- 
tea, mutton and chicken broth, tender beef steak, etc. j 

When the strength will permit, gentle exercise must be taken in | 
the open air, but not on horseback, or in hard, jolting carriages. i 

As soon as the inflammation is subdued, some mild laxative (35) | 
may be given, in connection with an infusion of wild-cherry bark, ! 
geranium, and Solomon's sea], equal parts. j 

Wind Colic— Flatulent Colic. — Interalgia. 

This is a severe and distressing pain in the bowels, — sometimes a 
stoppage, and a swelling about the pit of the stomach and the navel. 
What children call belly ache is a mild form of it. The wind passing 



DISEASES OF THE ABDOMINAL CAVITY. 281 

from one portion of the bowel to another, causes a rumbling noise. 
The pain is not increased by pressure ; and this distinguishes it from 
the pain of inflammation. It moves about, too, from place to place, 
and is much relieved by the escape of wind up or down. 

The complaint may be caused by a weakness in the digestive or- 
gans, by eating indigestible food, or unripe fruit, by costiveness, and 
by taking cold. Some persons always have the colic excited by eat- 
ing certain kinds of fruit. 

Treatment. — When the complaint is caused by an indigestible sub- 
stance taken into the stomach, the offending matter should be thrown 
off by an emetic as soon as possible. If this does not bring relief, 
let it be followed by a dose of salts, salts and senna, compound infu- 
sion of senna, elixir salutis, elixir pro., or sweet tincture of rhubarb. 
If there is no sickness of the stomach, a little essence of peppermint 
or spearmint in hot water, or brandy, gin, or whiskey, in hot water, 
may prove sufficient to expel the wind, and relieve the pain. Ginger 
and hot water does well with some. If there be costiveness, and the 
pain is obstinate, let the bowels be unloaded by a stimulating injec- 
tion (248) (249) (250). 

Air-Swellings. — Ti/mpanites. 

It is quite common for persons in delicate health, — particularly 
females, — to have their stomach and bowels swell up, sometimes 
slowly, sometimes suddenly, so that they cannot bring their clothes 
together. They do not know what to make of it; it sometimes 
alarms them ; and they ask their medical adviser what it means. 

Explanation. — This is the meaning of it. It is neither more nor 
less, in many castas, than the air within the muscles and membranes 
swelling up and distending them in consequence of their being in a 
weakened condition. There are two ways in which the flesh may be 
caused to bloat. It may be caused by placing a cupping glass over 
it, and taking off' the external air. When this is done, the air within 
seeks to fill the vacuum above, and lifts up the flesh. So, likewise, if 
the parts are weak, and lose their tone, they give way, and let more 
air into their substance, and they stretch and puff up. 

But these swellings may occur from an accumulation of air within 
the bowels, and also within the abdominal cavity. This latter gives 
the belly a peculiarly hard feel, like the head of a drum, and when it 
is pressed upon with the fingers, no indentation remains. 

Treatment. — If the air be in the intestinal tube, a stimulating in- 
jection may bring away the wind. It may be composed of one pint 
of infusion of spearmint, one gill of tincture of prickly ash berries, 
half a gill of tincture of assafcetida, and a teaspoonful of ginger. 
The bowels of the patient should be rubbed for a long time ; and in 
all forms of the complaint, it would be well to do this every day. 
Sometimes the wind may be drawn off by inserting into the rectum 
a long gum-elastic tube. 

36 



282 DISEASES OF THE ABDOMINAL CAVITY. 

The best constitutional remedies are tonics, — iron, quinine, mineral 
acids, and bitters, (48) (55) (59) (60) (62) (63) (64) (71) (73). 

Exercise in the open air, and a careful regulation of the diet will 
do much towards removing these troubles. Costiveness must be care- 
fully guarded against. 

Bilious Colic. 

This is a dangerous disease. There is pain of a griping, twisting, 
tearing kind, — what the ancients called atrocious pain. It is chiefly 
about the navel, but sometimes tortures the whole belly. It comes 
and goes in paroxysms. Sometimes the abdomen is drawn in, at 
other times it is swelled out, and stretched like a drum-head. At 
first the pain is relieved by pressure ; after a time the belly is tender to 
the touch. There is thirst and heat, and a discharge of bilious mat- 
ter from the stomach. In the worst cases, the pulse is small, the face 
pale, the features shrunk, and the whole body covered with cold 
sweat. While the head is hot, the feet are cold. In advanced stages 
of the disease, the action of the bowels is sometimes reversed, and 
the fecal matter forced up through the mouth. 

Canses. — Costiveness, irritating substances in the bowels, thick, 
vitiated bile, long exposure to cold, torpidity of the liver and skin, 
great unnatural heat, with dampness, etc. 

Treatment, — Administer an active purgative injection immediately 
(251) (252). Internally, dioscorein, camphor, etc. (340), every fifteen 
minutes, till relief is obtained, — at the same time covering the whole 
belly with a large mustard poultice. A strong decoction of the wild 
yam root, drank freely, is a medicine of some value, — so is a decoc- 
tion of scullcap and high-cranberry bark, equal parts. This latter 
article is excellent in spasmodic affections, on which account, it has 
gained the name of cramp bark. The sickness at the stomach may 
be allayed frequently by effervescing drafts, to which twenty -five or 
thirty drops of laudanum are added. Croton oil, given in one-drop 
doses, done up with crumb of bread, will sometimes succeed well as 
a purgative medicine ; or castor oil and spirits of turpentine, equal 
parts, in two great spoonful doses, may be tried before the croton 
oil. 

The warm bath is worth remembering, and trying, too, if the 
means are at hand. Hot fomentations of the bowels with a decoc- 
tion of poppy leaves, or stramonium leaves, or hops and lobelia, or 
hops, wormwood, and boneset, are not to be overlooked. Bottles 
filled with hot water, or hot bricks rolled in flannel, should be placed 
at the back and feet, to promote perspiration. 

Persons subject to this complaint, may derive advantage from one 
pill composed of extract of high cranberry bark, etc. (lOO), taken after 
each meal for some months. At the same time a reasonable amount 
of exercise should be taken out of doors, and a sponge bath, with fric- 
tion, be employed daily. Care should be taken not to be often ex- 
posed to the hot sun. 



DISEASES OF THE ABDOMINAL CAVITY. 283 



Painters' Colic. — Colica Pictomim. 

This form of colic is caused by the slow introduction of lead into 
the system, — generally the carbonate of lead. It passes under the 
different English names of painters' colic, Devonshire colic, and dry 
belly-ache. The first of these is the name by which it is most com- 
monly known, from its frequent occurrence among painters, who use 
white lead (carbonate of lead) a great deal in the preparation of their 
colors. 

8}iiii)toms. — The disease generally comes on in a very gradual 
way. At first, the appetite is impaired,' there is slight nausea, belch- 
ing of wind, languor, very obstinate costiveness, transient pains, with 
a feeling of weight and tightness in the belly, and a disinclination to 
make any exertion. 

By degrees, the pain in the bowels, and particularly about the na- 
' vel, becomes more severe, and has a tiuisting character. The belly 
I becomes hard, drawn in, and a little tender to pressure, and the stom- 
ach very irritable. The pain occasionally slacks off a little ; but 
j never, even in mild cases, entirely stops, as in other kinds of colic. 
i In some severe cases, the pain runs up to the chest, and down the 

arms ; also down to the bladder, causing the urine to be passed with 
pain and difficulty, and giving a sense of weight and bearing down 
in the lower belly. During the severest pains, the countenance is 
pale, contracted, and full of suffering; cold sweats break out upon 
the face and limbs, and anxiety and agitation seize the patient. 

When the disease is not seasonably removed, it degenerates into 
the chronic form, the mental and physical energies become torpid, 
the circulation in the small vessels inactive, the skin dry, harsh, shriv- 
elled, pale, sallow, or of a leaden hue, the temper irritable, despond- 
ing and gloomy, and the body wasted. Beside all this, the muscles 
which lift up the lower arm become palsied^ so that, when the arms 
are raised, the hands hang down in a helpless condition. In some 
cases, there is a blue line along the edges of the gums. 

Treatment. — For relieving the pain and opening the bowels, the 
treatment should be very much the same as that for bilious colic. 
There is one article, however, which is thought to have some special 
influence in curing this disease, after it has become chronic ; it is 
alum. Fifteen grains of alum, two of aloes, two of jalap, and four 
of Dover's powder, may be mixed, and taken for a dose two or three 
times a day. If the muscles of the arm be palsied, one sixteenth of 
a grain of strychnine may be added to the above. The aromatic sul- 
phuric acid, taken as a drink, fifteen drops to the tumblerful of water, 
is always worthy of trial. 

The use of the electromagnetic machine may be tried for the palsy; 
or a splint applied to the arm and hand, with vigorous friction applied 
once or twice a day, will sometimes do much for recovering the use 
of the muscles. 

But the best remedy for the palsied muscles is iodide of potassium 



284 DISEASES OF TPIE ABDOMINAL CAVITY. 

(146), taken freely. The sulphuret of potassa, one ounce dissolved in 
a quart of water, and taken in teaspoonful doses, three times a day, is 
also worth a trial. The affected arm should be soaked an hour, once 
or twice a day, in the same amount of this latter salt, dissolved in a 
gallon of water. 

Means of Prevention. — The numerous persons who work in lead, 
should comb their hair with a fine comb, wash their hands and face, 
and rinse their mouth several times a day, and also wash the w^hole 
person wdth soap once or twice a week, and with clear water, or sal- 
eratus and water, once a day. Their working clothes should be of a 
kind to admit of being washed once or twice a week, and they should 
be put off for others when out of the workshop. A paper cap should 
be worn wdiile at w^ork. The food of the workmen should not be ex- 
posed to the vapors or floating particles of lead, and consequently 
should not be carried into the shop ; and when much of the poison is 
floating in the air of the work room, it is a good plan to wear a mask 
to prevent its being drawn with the breath into the throat and lungs. 

It has been said that those who eat freely of fat meats, butter, and 
other oily substances, are not attacked by the disease, though exposed 
to the poison. I know not what protection this can give, unless the 
skin is in this way kept more oily, which prevents the absorption of 
the poison. This would seem- to afford a hint in favor of anointing 
the whole person once or twice a week with sweet oil. 

Cos tiveness.— Constipation. 

Few disorders are more common than costiveness. By this term 
I mean a sluggish state of the bowels, which causes them to retain 
the feces longer than is warranted by health. In this complaint, the 
discharges from the bowels are not always less frequent than they 
should be, but they are less in quantity, are compacted and hard, and 
are passed by hard straining, and sometimes with considerable pain. 

Symptoms. — Headache, dizziness, fevejishness, bad feelings in the 
head not easily described, loss of appetite, sometimes nausea, but 
little desire to go to stool, a weight and heaviness about the lower 
part of the belly, and a sense of confinement over the whole body. 

Causes. — Sedentary habits, particularly when connected with close 
application of the mind ; astringent articles of medicine ; stimulating 
diet, composed chiefly of animal food ; various diseases, particularly 
those of a nervous character, and especially, a neglect to evacuate 
the bowels at proper periods. All these causes tend to weaken the 
bowels, and gradually to arrest that peculiar undulatory movement, 
or worm-like action, called the peristaltic motion of the bowels. It 
is this continual contraction of the muscular fibres of the intestines 
from above downward, which pushes the contents steadily along; and 
whatever weakens the force of this vernicular play of the intestinal 
w^alls, brings on constipation. 

Treatment. — One of the first things to be done is to establish the 



DISEASES OF THE ABDOMINAL CAVITY. 285 

habit of attempting' to evacuate the bowels at a particular hour every 
day. The best time for most persons is soon after breakfast in the 
morning. Whether successful or not, the attempt to procure an evac- 
uation should on no account be omitted. This regularity will often 
do much to break up the costive habit. 

Diet — To this should be added a careful regulation of the diet. 
The quantity of food taken should be no" greater than can be easily 
digested. Full meals which distend the stomach and cause it to press 
upon the bowels embarrass their movements. Bread made from fine 
wheat flour is an abomination in this disorder. Eat only that from 
unbolted liour. Cracked wheat, prepared as directed among dietetic 
preparations, is excellent for the cure of costiveness. Fresh vegeta- 
bles, as peas, beans, potatoes, squashes, and ripe fruits, in their sea- 
son, are all wholesome, and tend to relieve costiveness. But rich pies, 
puddings, cakes, doughnuts, and all that sort of trash, increase the 
disorder. ' 

"Water Injeetioiis, etc. — One of the best remedies is water, cold or 
tepid, according to the condition of the patient, injected into the bow- 
els with the domestic syringe. The best syringes for this purpose are 
Mattson's, and Davidson's, one of \vhich should be in every family. 
Water used externally, in the form of the sponge bath, is also useful. 

Medicines. — All the above measures having failed to give relief, 
take JMcttauers aperient, or the neutralizing mixture. If these fail, 
podophyUin, etc. (36), may have a trial. A cold decoction of thorough- 
wort, drank daily, sometimes has an excellent effect. It must be re- 
membered that medicines viay make matters worse, and they should 
be used cautiously. 

All the causes of the disease must of course be avoided. 



Piles.— Hemorrhoids. 

There are few complaints more common than the piles, and 
scarcely any which cause more trouble and misery. They consist in 
a fulness of blood, and languid circulation in the lower portion of the 
lower bowel or rectum. In consequence of this congestion, either the 
veins of the gut become enlarged or varicose, or the blood gets infil- 
trated into the cells beneatu the mucous membrane, and collects so 
as to form bloody tumors. 

These tumors, which are seldom absent, are the leading features of 
the piles. They sometimes appear externally, around the anus ; this 
is external piles. At other times they are within the bowel ; the com- 
plaint is then called internal piles. They are called bleeding piles 
when blood is discharged, and blind piles when it is not. 

Symptoms. — Usually there is a sense of weight and weakness in 
the lower part of the back and loins, with a painful itching about the 
anus. On going to stool, there is a burning, cutting pain experienced, 
which is followed by bearing down and tenesmus. If it be bleeding 



286 DISEASES OF THE ABDOMINAL CAVITY. 

piles, the little tumors will bleed at every motion of the bowels. 
There are frequently disagreeable sensations in the head, general las- 
situde, an irritable state of mind, and a sense of fulness and anxiety 
in the stomach. The pains experienced range all the way from the 
slightest twinges up to the most terrible sufferings, which appear like 
tearing the body asunder. 

Causes. — Everything that irritates the lower bowel, and causes a 
determination of blood to the part. All drastic physic has this effect, 

— particularly aloes, which acts especially upon the rectum. Habit- 
ual costiveness, straining at stools, riding much on horseback, sitting 
a great deal, tight lacing, high-seasoned food, and stimulation gener- 
ally, lifting and carrying heavy weights, and indurations of the liver. 

Females during pregnancy are much afflicted with piles, which are 
induced by the costiveness so peculiar to their condition, and by the 
pressure of the enlarged womb upon the veins of the pelvis. 

Treatment. — This should be medicinal and dietetic. 

Great care must be observed not to push medication too far. Ac- 
tive purging will do great mischief. Yet costiveness must in some 
way be corrected. For this purpose, no remedy that I have ever 
tried has done better in this complaint than an electuary composed 
of confection of senna, flowers of sulphur and cream of tartar (6), 
taken in doses just sufficient to procure one natural motion of the 
bowels each day. Pills made of extract of thoroiighwort are said to 
do well. If the liver be in a congested state, take some of the arti- 
cles recommended in the chronic inflammation of that organ. 

For the local treatment, nothing is better than two ounces of lard 
and one dram of the flowers of sulphur mixed, and rubbed between 
two plates of lead until they are well blackened. This ointment is 
not only soothing, but curative, both in the bleeding and blind piles. 
An ointment of almost equal excellence may be made from one hand- 
ful each of witch hazel bark, white oak bark, and sweet-appletree 
bark, boiled together in one pint of water down to one third of a pint. 
Then strain, and add two ounces of lard, and simmer away the water, 

— stirring continually before and after removing from the fire, till it 
cools. 

If there is much inflammation and distress, an emolient and sooth- 
ing poultice should be applied, composed of slippery elm bark and 
stramonium or poke leaves. Steaming the parts is sometimes useful, 
by sitting over a hot decoction of hops, stramonium, and poke. 

Piles may often be cured by the use of the domestic syringe. Daily 
injections of cool or cold water will do much to strengthen the bowel, 
and restore the dilated veins to their natural condition. 

The food should be of a laxative nature, corn bread, rye pudding, 
bread of unbolted wheat flour, mealy potatoes, ripe fruit, pudding 
and milk, buckwheat cakes, broths, and a little tender meat once a 
day. 



DISEASES OF THE ABDOMINAL CAVITY. 287 



Looseness of the Bowels. — Diarrhoea. 

Looseness, or relax of the bowels, is manifested by frequent, copi- 
ous, and thin, or unusually liquid discharges. The excessive discharge 
mav be caused either by irritating and unwholesome food, by inflam- 
mation and ulceration of some portion of the bowels, or by debility. 

Sjinptoms. — Rumbling noise in the bowels, with more or less 
weight and bearing down, and uneasiness in the lower part of the 
bowels. This pressing down and uneasiness are relieved as soon as 
the evacuation takes place, but returns when another is near at hand. 
Griping is generally present, the strength is reduced, and the skin is 
pale, dry, and, after a time, sallow. 

Treatiiieut. — When the complaint is caused by irritating food, it 
will generally stop as soon as the offending substance is removed, and 
not much medicine will be required. 

To neutralize any acidity, to remove wind, allay irritation, and 
strengthen the stomach, the compound syrup of rheubarb and potassa 
is well adapted, given in tablespoonful doses, every hour, till it oper- 
ates. A little paragoric added to it occasionally, or essence of pep- 
permint, or spearmint, may aid its good effects. 

If nausea and vomiting are present, put a mustard poultice upon 
the stomach, and give a few drops of laudanum. If there is much 
griping, give an injection (248), with twenty drops of laudanum in it. 
A common diarrhoea may generally be arrested at .once by prescrip- 
tions 159 or 162, in teaspoonful doses, iafter each discharge. 

When there is inflammation and ulceration of the bowel, the treat- 
ment must be similar to that for dysentery, — fomentations exter- 
nally, and the occasional use of starch injectio mild cathartics (9) 
(10), and Dover's powder internally. 

Chronic Diarrhoea. 

The acute form of diarrhoea, not being properly managed, often 
runs on, and becomes chronic, and is at times exceedingly diflicult to 
cure. 

Symptoms. — Frequent discharges, generally with some pain and 
griping, restlessness, thirst, poor appetite, debility, loss of flesh, dry, 
rough, and somewhat sallow skin, and tongue dry and dark-colored. 
The food often passes through the bowels pretty much in the condi- 
tion in which it was swallowed. The liver is generally out of order, 
and the bowels are frequently afflicted with a low grade of inflam- 
mation. 

Treatment. — In this form if the disease, astringents and tonics will 
generally be required. Sometimes a teaspoonful of brandy, in a little 
sweetened water, or in clear water, several times a day, will effect a 
cure. Good cherry brandy is a valuable remedy ; so is blackberry 



288 DISEASES OF THE ABDOMINAL CAVITY. 

brandy. Many of the worst cases have been cured by taking no 
nourishment, for a long time, except milk, with a little lime water 
in it. 

When the liver is involved in the complaint, as evinced by light- 
colored stools, leptandrin, geranium, etc. (341), may be given with 
advantage. 

In some instances, when there is considerable debility, pills of 
quinine, catechu, etc. (342), will do well. 

A sponge bath must be taken daily, and the skin be well rubbed 
after it. 

Cholera Morbus. 

The above name is given to a disease common in warm weather, 
and characterized by sudden attacks of bilious vomiting and purging, 
with severe pain in the belly, cramps, and general fever and subse- 
quent prostration. The great amount of bile secreted and discharged 
has given it the name cholera^ from choler, bile. 

Sj'iiiptoms, — The disease begins by sickness and distress at the 
stomach, which is succeeded by violent gri pings, with vomiting of 
thin, dirty-yellowish, whitish, or greenish fluid, with discharges from 
the bowels similar to that vomited. The nausea and distress, with 
some few exceptions, continue between the vomiting and purging, 
and the pain, at times, is intense. The pulse is rapid, soon becoming 
small and feeble, the tongue dry, the urine high-colored, and there is 
much thirst, though no drink can be retained on the stomach. It is 
to be distinguished from diarrhoea by the bilious discharges. 

Treatment. — Apply a large mustard poultice over the stomach and 
liver, and give tablespoonful doses of compound powder of rhubarb 
and potassa, every half hour, until the vomiting and nausea are 
checked, adding to each dose five to ten drops of laudanum, if neces- 
sary. Perhaps it would generally be best, however, to give liberal 
draughts of warm water, at first, or flax-seed tea, that all the solid con- 
tents of the stomach and bowels may be washed out. 

A teaspoonful of laudanum in a wineglassful of flax-seed tea, given 
as an injection, every two hours, will sometimes do excellently well ; or 
a tea made of chamomile flowers, or Colombo, and made sour by a few 
drops of nitric or sulphuric acid, and given internally, will sometimes 
succeed better than most other things. One grain of morphine and 
thirty grains of bicarbonate of soda dissolved in an ounce of sweet 
tincture of rhubarb, and given in teaspoonful doses, every half hour 
will often have a fine effect. The prescription 162 is also valuable. 

Hot bricks should be applied to the feet, and warm flannels, or 
other kinds of dry heat, to the whole body. 

Asiatic Cholera. 

Beside the above name, this fearful disease has been called epi- 
demic cholera, malignant cholera, spasmodic cholera, and cholera 



DISEASES OF THE ABDOMINAL CAVITY. 289 

asphyxia. It first attracted notice in Bengal, in 1817, whence it 
spread westward through Europe, and in June, 1832, it reached Que- 
bec, on this continent. 

S>iiiptoiiis. — First Stu^e. — The first, premonitory stage, is marked 
by derangement of the digestive organs, rumbling in the bowels, pain 
in the loins or knees, twitchings of the calves of the legs, impaired 
appetite, thirst, and especially, a slight diarrhoea ; and these symp- 
toms continue from a few hours to several days. I should add to 
these symptoms what is said to have been recently discovered, namely, 
that for several days before the attack, the pulse is down to forty or 
fifty beats in a minute. This, if it prove to be reliable, is a very valu- 
able symptom. 

Second ^t^^e, — This stage is marked by vomiting and purging a 
thin, colorless fluid, looking almost exactly like rice water ; by severe 
cramps in the calves of the legs, which soon attack the bowels and 
stomach. These cramps are excessively painful, and draw the mus- 
cles into knots. The tongue is pale and moist ; the pulse feeble, 
though sometimes full and firm ; the breathing hurried, with distress 
about the heart ; great thirst ; a feeling of internal warmth ; and the 
secretion of urine entirely stopped. 

These thin, colorless discharges by vomiting and purging, are the 
serum or watery portion of the blood, which oozes through the sides 
of the blood-vessels, and runs oft' rapidly, leaving the crassamentum, 
or red, solid part of the blood, stranded upon the inner surfaces of the 
arteries and veins. When so much of this is discharged that the 
blood cannot circulate freely, the patient sinks into the 

Third Stiig;e, which is characterized by great prostration ; pulse 
hardly perceptible ; skin cold and clammy ; face blue or purple, and 
eyes much sunken ; hands dark-colored and sodden, looking like a 
washerwoman's ; breathing short and laborious ; a sense of great heat 
in the stomach ; and intense thirst. Recoveries from this stage sel- 
dom take place. 

Treatment. — In the first stage, the diarrhoea should receive the 
most prompt attention. From five to ten drops of laudanum, re- 
peated a few times, every three hours, will generally put a stop to it. 
Morphine (162) is also a suitable remedy. The compound syrup of 
rhubarb and potassa, with some other articles (343), in tablespoonful 
doses, every hour, till it operates gently, is worth a trial. The diet 
should of course be very carefully regulated at such a time, though 
not particularly changed, except to leave oft' any indigestible article 
which is known to be injurious, and to be made a little more sparing 
than in a time of perfect health. 

When the second stage has set in, or the stage of vomiting, purg- 
ing, and cramps, the treatment must be energetic. The sinking pow- 
ers must be sustained by chloroform, opium, and ammonia (llO), or 
by camphor, opium, and cayenne (344), giving one pill every hour. 
Brandy may also be given freely. 

37 



290 DISEASES OE THE ABDO:\IIXAL CAVITY 

The warmth of the surface must be promoted by all possible means, 
hot bricks and bottles, tincture of cayenne, friction, etc. 

In the third stage, the remedies recommended above are to be pur- 
sued with increased energy, particularly the stimulants, and the efforts 
to promote the warmth of the surface. 

Dysentery.— Bloody Flux. — Colitis. 

This is an inflammation of the mucous membrane lining the lower 
or large bowels. The small bowels begin at the stomach, and are 
eight or ten yards long ; being largest near the stomach, and dimin- 
ishing in size as they approach their termination at the caecum. The 
lower or large bowels are two or three times as large as the small 
ones, and from their junction with the latter, they extend about six 
feet to the outlet, or anus. The large bowels are composed of the 
caecum, the colon, and the rectum. The rectum is about one foot in 
length. 

In most cases of dysentery, the rectum, and about half the adjoin- 
ing portion of the colon, experience the chief force of the inflamma- 
tion. Sometimes the whole of the colon and caecum are affected. 
Sometimes the mucous membrane lining these is ulcerated, and, be- 
coming wholly disorganized, passes off in shreds. 

Symptoms. — The disease comes on with loss of appetite, costive- 
ness, lassitude, shivering, heat of skin, and quick pulse. These are 
followed by griping pain in the bowels, and a constant desire to pass 
their contents. In general the passages are small, composed of mucus 
mixed with blood. These passages are attended and followed by 
severe gripings and inclination to strain, learnedly called tormina, and 
tenesmus. They are sometimes, in the early stages, attended by nau- 
sea and vomiting. The natural feces, which do not pass off much, 
are small in quantity, and formed into round, compact balls, or irreg- 
ular, hardened lumps. This tenesmus, or great desire to strain, will 
continue, perhaps increase, for several days, — the discharges being 
mostly blood in some cases, and chiefly mucus in others. Having, 
generally, but little odor, at first, these discharges become, as the dis- 
ease advances, exceedingly offensive. 

Ciinses. — Dysentery is very frequently caused by sudden changes 
from hot to cold, by which sweating is suddenly checked, and the 
blood repelled from the surface. Hot climates, and dry, hot weather 
are predisposing causes. All green, unripe, and unwholesome food ; 
and all indigestible food of every sort, may induce it. 

Treatment. — In mild cases, give a tablespoonful of castor oil and 
two teaspoonfuls of paragoric, mixed, once a day. Sometimes, in 
place of the above, a dose of rochelle powder, dissolved in water, with 
thirty or forty drops of laudanum, may be taken. A moderate quan- 
tity of flax-seed or slippery elm tea, may be taken as a drink, and the 
bowels be well emptied by an injection of stajch. ^ • 

When there is much pain in the bowels, a mustard poultice laid 



DISEASES OF THE ABDOMINxVL CxVVITY. 291 

upon them, will have a good effect. The starch injections should, in 
such case, have half a teaspoonful of laudanum mixed with it. The 
compound syrup of rhubarb and potassa will often act favorably, given 
in tablespoonful doses. 

If there is reason to suppose the liver is affected, give podophyllin, 
etc. (46). 

The patient should not be allowed to sit up, and must be kept very 
still, and be allowed only a very scanty diet, as flour porridge, well 
boiled, rice water, etc. 

Chronic Dysentery. 

When dysentery "runs on" for some time, it may become 

chronic. 

Syniptoms. — Looseness of bowels, — the discharges being un- 
healthy, more or less bloody, attended by bearing down, or a desire 
to strain, and being in number from two to forty a day. There is 
great debility, the pulse is weak and quick, the tongue slightly furred, 
the appetite lost, the face pale and sallow, and the skin dry and parched. 
Sometimes the relax alternates with costiveness. 

Treatment. — In this form of the complaint, astringents will be 
necessary (159) (161) (162) (345) (346) (347). 

Injections may be used, if necessary, composed of nitrate of sil- 
ver, fifteen grains to the ounce of water, or an infusion of golden seal, 
with a little tincture of prickly-ash berries added to it. 

The diet must be very light, easy of digestion, and nutritious. In 
some cases, it should be composed chiefly of wheat flour porridge, or 
boiled milk and boiled rice. In other cases, a little tender beef steak 
should be taken once a day. 

Worms. — Vermes, 

The intestinal canal is subject to various disturbances from the 
presence of worms. Of these troublesome tenants, there are three 
principal varieties. 

The Ascaris, or pin-worm^ called also maw or thread worm, is a 
small, white, thread-like worm from half an inch to an inch in length. 
These worms live, in great numbers, in the rectum, where they excite 
great irritation and itching. 

The Limibricus, or ascaris lumbricoides, is a round worm, about an 
eighth of an inch in thickness, and from an eighth to a quarter of a 
yard in length. Its color varies from a milky whiteness to a deep 
red. It generally occupies the small bowels. 

The Tenia Solanum, or tape-iuorm, is a flat worm, with four suckers 
at the head, is from a few feet to some hundreds in length, and full of 
joints. It dwells in the small bowels, and feeds on the chyle as it 
comes along, before it is absorbed by the lacteals. In this way, it 



292 DISEASES OF THE ABDOMINAL CAVITY. 

robs the body of nourishment, and produces great loss of flesh, and 
an enormous appetite. 

SjTiiptoms. — In the grown person the symptoms of worms are 
quite obscure, except an intolerable itching within the anus, which 
generally indicates pin-worms. 

In children worms are indicated by paleness, itching of the nose, 
grinding of the teeth and starting in sleep, irregular appetite, bad 
breath, swelled upper lip, picking of the nose, hard swelled belly, and 
one cheek constantly flushed. 

Treatment. — For expelling worms various articles have been used. 
Among these spirits of turpentine (155) has a high reputation. The 
following preparation does well : Spirits of turpentine, half an ounce ; 
oil of anise, half an ounce ; castor oil one ounce ; worm-seed oil, one 
ounce. Mix. The dose for a child one or two years old, is ten to 
twenty drops, every two or three hours. In two or three days, a 
brisk physic should be given. The worm powder is quite success- 
ful. 

One of the most popular remedies is the pink-root. It should be 
united with a purgative. The following is a good preparation : Pink- 
root and senna, each half an ounce ; bitartrate of potassa, one dram ; 
pulverized jalap, half a dram ; cardamom seeds, half a dram ; extract 
of liquorice, two drams. Mix, and add half a pint of boiling water. 
Let the whole steep an hour. Give a tablespoonful or two, occasion- 
ally, till the worms are expelled. 

An injection composed of quassia (66), or aloes (22), or of simple 
sweet oil, is very effectual in removing pin-worms from the lower 
bowel. So is an injection composed of the red iodide of mercury, 
one grain ; iodide of potassium, half a grain ; and two pints of 
water. 

Most of the above preparations are thought to be successful in ex- 
pelling all kinds of worms ; but for the tape-ivorm^ no other remedy 
has yet shown itself as effectual as pumpkin-seeds. The seeds should 
be well bruised, and steeped in water. This should be drank freely 
for several days, if need be. It is believed to be a sure remedy, even 
in cases of several years' standing. 

In all cases of worms, the diet should be carefully chosen, and be 
connected with proper exercise, pure air, frequent bathing, and all 
those measures which tend to improve the general health. 

After the expulsion of the worms, tonics should always be taken 
to strengthen the bowels, that the same evil may not return. 

Acute Inflammation of the Kidneys. — Nephritis. 

Before speaking of this disease, I wish to give the reader a general 
idea of a kidney, and shall do so by the use of two cuts. 

Fig. 108 presents the external surface of the right kidney, with its 
renal capsule mounted on top ; f, being its upper edge ; /, /i, superior 
and inferior branches of the emulgent artery ; c, d^ e, three branches 
of the emulgent vein ; a, the pelvis of the ureter ; 6, the ureter. 



DISEASES OF TJIE ABDOMINAL CAVITY. 



293 



Fig. 109 is the same kidney laid open ; 1, being the supra renal 
capsule ; 2, the vascular portion ; 3, 3, the tuberlar portion, consisting 
of cones ; 4, 4, two of the calices receiving the apex of their corres- 
ponding cones ; D, 5, 5, the three infundibula ; 6, the pelvis ; and 7, 
the ureter. 



Fig. lOS. 



Fia. 109. 





The kidneys are glands, and their office is to draw or strain off 
from the body those effete or worn-out particles, or products of decay 
lohich contain nitrogen^ while the licer takes away those carbonaceous 
matters icliich have no nitrog-en. These useless substances which go 
out through the kidneys are generally in the form of urea. In carry- 
ing off these matters, the kidneys may have more to do than properly 
belongs to them ; and may be so stimulated, or irritated, or injured 
in some way, as to become inflamed. 

S}iiiptoiiiS. — Like most other inflammatory diseases, it begins with 
cold chills and rigors, especially in the back and loins, followed by 
fever and pain. The pain frequently extends to the bladder, the loins, 
and the thighs, and is of a severe, lancinating kind, — though some- 
times obtuse. Pressure, motion, straining, or taking a full breath, add 
to its pungency. The urine is scanty, high-colored, sometimes bloody, 
and can only be passed drop by drop. In the loins there is a sense 
of heat, gnawing, and constriction ; the bowels are either constipated, 
or relaxed by diarrhoea. A numbness of the thigh, and drawing up 
of the testicle on the affected side, are marked and peculiar symptoms. 
In some cases, there are nausea, vomiting, oppression at the stomach, 
faintness, hiccough, drum-head distention, and rumbling of the bowels. 
The skin is hot and dry, the pulse hard and frequent. 

Causes. — The use of cantharides, oil of turpentine, and other di- 
uretics, taking cold, violent exercise, mechanical injuries, the transla- 
tion of rheumatism or gout, the striking in of skin eruptions, and 
gravelly formations in the kidneys or ureters. 



294 DISEASES OF THE ABDOMINAL CAVITY. 

Distinctions. — This disease is to be distinguished from colic by 
the pain being increased by pressure, and by the frequent but difficult 
discharge of red urine ; from lumbago^ from its being confined fre- 
quently to one side, and also by the urinary troubles, and by the 
nausea and vomiting; and from all other diseases, by the numbness 
of the thigh, and the drawing up of the testicles. 

Terminations of tlie Disease. — It runs a rapid course, and may 
terminate by resolution, or by suppuration. When the latter happens, 
it is indicated by the decline of the more violent symptoms, a throb- 
bing and a sense of weight, with chills, followed by flushes of heat,. 
and sweating. The matter formed, generally small in quantity, may 
pass into the cavity of the kidney, and thence through the bladder to 
a natural outlet with the urine. 

Treatment. — Either put the feet into a hot mustard bath, or put 
mustard drafts upon them. At the same time apply a large mustard 
poultice upon the small of the back, and follow it up with hot fomen- 
tations of stramonium leaves and hops, or stramonium and worm- 
wood or tansy. 

Let perspiration be induced as soon as possible by five to ten ten- 
drop doses of tincture of veratrum viride, repeated every hour, or by 
teaspoonful doses of the compound tincture of Virginia snake-root, 
given every half hour. 

If costiveness exist, the bowels must be opened by epsom salts, 
cream of tartar, or salts of tartar ; or by copious injections of warm 
water, containing a few drops of the tincture of arnica leaves. Such 
injections not only unload the bowels, but act as a local bath, by lying 
in the bowel near the inflamed kidneys. 

The drinks must be mucilaginous and diuretic. The marshmal- 
low root and peach leaves, slippery-elm bark, flax-seed, mullein, elder 
blows, haircap-moss, and cleavers, are all valuable. If the disease is 
caused by gravel, twenty drops of liquor potassae, largely dilated 
with flax-seed and upland-cranberry tea, and taken freely as a drink, 
is excellent. 

Chronic Inflammation of the Kidneys. 

This is frequently the result of the acute form of the disease, but is 
also produced by injuries, and other causes. 

Symptoms. — A weakness in the small of the back, and a dull, 
heavy pain in the kidneys. The urine is passed often, and in small 
quantities. It is alkaline, — sometimes white and milky, — and has 
in it deposits of phosphate of lime, and triple phosphates. 

Treatment. — Infusions of pipsissewa, uva ursi, trailing arbutus, 
wild carrot, queen of the meadow, buchu leaves, or foxglove are use- 
ful diuretics, and may be taken with advantage. 

The bowels must be kept open with some gentle physic (18), if 
they are costive ; and the alkaline sponge bath, with ' friction, be used 
daily. 



1 — 

PISEAS"FS OF THE ABDOMINAL CAVITY. 295 

An eruption may be brought out upon the small of the back by 
rubbing on a few drops of croton oil ; or, if the patient prefer it, a 
mustard poultice may be applied two or three times a week. 

The food should be nutritious, and easily digested, and a little exer- 
cise be taken daily in the open air. 

Acute Inflammation of the Bladder. — Ci/stitis. 

This disease affects the lining membrane of the bladder, — some- 
times its muscular substance. It may attack the upper portion, the 
middle, or the neck of this organ. It runs a rapid course. 

Sjiiiptoins. — Burning, piercing, and throbbing pain in the region 
of the bladder. The pain extends to the perineum, and in some 
cases, to the testicles and thighs, and is much increased by pressure. 
The perineum, the space between the fundament and testicles, feels 
sore to the touch. The desire to pass urine is incessant, but the 
etTort to do so is mainly ineffectual. The water passes off drop by 
drop, with great pain, or is entirely stopped, — causing enlargement 
of the bladder, and great distress. Mucus from the inflamed lining 
of the bladder passes off with the water. Nausea, vomiting, and 
great anxiety are common. The bowels are bound, and when the 
disease is on the side next the lower bowel, there is a desire to empty 
the bowels ; and if the inflammation be in the neck, there is great 
pain in the perineum, and frequently an entire retention of the water. 
The pulse is full, hard, and frequent, the skin hot and dry, the thirst 
urgent, and the patient restless and dejected. 

Causes. — This disease may be produced by taking cantharides and 
turpentine ; by irritating substances forced into the bladder wdth a 
syringe, or by pushing bougies or catheters into it ; by gravel stones 
in the bladder; by retained urine; by external injuries; by gonor- 
rhoea ; and by cold applied to the feet, or to the lower portion of the 
abdomen. 

Treatiiieiit. — If the urine be retained, it is of the utmost impor- 
tance that it be early drawn off with the catheter, lest a distention of 
the bladder bring on mortification. Great care is required not to pro- 
duce irritation by any roughness in introducing the instrument. 

Leeches should be applied upon the lower part of the bowels, the 
perineum, and around the anus. When these are removed, warm 
poultices should be applied. Cold compresses will often do as well. 
The bowels must be opened with epsom salts. Injections of warm 
water, with a few drops of tincture of arnica leaves, will act finely as 
a local bath, — the water being retained as long as possible. 

The tincture of veratrum viride will be required in five to ten-drop 
doses, or the compound tincture of Virginia snake-root, to induce 
perspiration. Dover's powders may sometimes be used for the same 
purpose. 

Drinks must be taken very sparingly. A small amount of cold in- 
fusion of slippery elm bark, or m^rshmallow and peach leaves, or 



ft 
296 DISEASES OF THE ABDOMINAL CAVITY. 

cleavers. This mucilaginous drink must be the beginning and the 
end of the diet during the active stage of the disease. 

Chronic Inflammation of the Bladder. — Cystirrhcea. 

This is much more common than the active form of the disease. 
It often arises from the same causes which produce acute inflamma- 
tion of the bladder. 

It often passes under the title of " catarrh of the bladder." It is 
a chronic inflammation of the mucous lining of the bladder, and is a 
very common and troublesome affection among old people. 

Symptoms. — Slight lancinating pains, with a feeling of heat in the 
region of the bladder, and a sense of weight and tenderness in the 
perineum; frequent and tormenting desire to pass water, with occa- 
sional spasmodic action of the bladder. The urine is loaded with 
tenacious mucous, just as the expectoration has large quantities of 
mucus in it when there is inflammation of the membrane lining the 
windpipe and bronchial tubes. When the water has stood a while, 
this mucus settles at the bottom of the vessel, leaving the fluid clear 
above. Great quantities of this are sometimes passed, — amounting 
even to pints in a day. The triple phosphates of magnesia and am- 
monia are often found in the water. 

Frequently there are derangements of the appetite and digestive 
functions, a white or brown fur upon the tongue, a harsh, dry skin, 
with thirst and general debility, — especially in the back and loins. 
Sometimes there is a little fever. 

Treatment. — To reduce the inflammation, apply leeches, or mus- 
tard, or croton oil, or a cold compress every night. 

As a diuretic, give an infusion of buchu, uva ursi, trailing arbutus, 
queen of the meadow, etc. Tincture of veratrum viride and sweet 
spirits of nitre (125) is a good remedy. The compound infusion of 
trailing arbutus is well recommended. So is the compound balsam 
of sulphur. An infusion of the pods of beans has been well spoken of. 

An injection into the bladder, once a day, of a tepid infusion of 
golden seal and Solomon's seal roots, may be of great service ; or an 
infusion of equal parts of golden seal, witch hazel, and geranium. 
It may be done with a gum elastic catheter, and a small syringe. 

The bowels must be kept open with the neutralizing mixture, or 
some other mild physic ; and the skin bathed with saleratus and 
water once a day, and rubbed well with a coarse towel. 

Should there be any scrofulous, or gouty, or rheumatic condition of 
the system, the remedies for those complaints may be used in addition 
to the above. 

Disease of the Supra-Renal Capsules. 

The supra-renal capsules are small bodies situated above the kid- 
neys. (Fig. 109, 1.) Their office is not well understood. It has 



DISEASES OF THE ABDOMINAL CAVITY. 297 

been found of late that they are subject to a disorder, having peculiar 
symptoms. This is a new disease. 

8jTiiptoiiis. — The most marked symptom is a peculiar change in 
the color of the skin, called "bronzing." This bronzing process be- 
gins in patches on those parts exposed to the sun, and to friction^ 
as the neck, the backs of the hands, the fronts of the thighs, and the 
arms. These patches look, in color, like spots upon a bronze statue, 
deprived of their gloss. 

Another marked symptom is a peculiar dchiUty^ which comes on 
without any apparent cause, — there being, generally, no evidence of 
organic disease, and no loss of flesh, — and is attended with faint- 
ings, loss of energy both of body and mind, a peculiar flabbiness of 
flesh, and an early death, apparently from sheer weakness. 

The blood becomes early depraved, and loses its coloring matter, 
as shown by the paleness of the skin where there is no bronzing. 

The pulse is generally very soft and compressible. The stomach is 
irritable, the appetite gone ; there is nausea, and sometimes vomiting, 
with pain and a sense of sinking at the pit of the stomach. Fre- 
quently there is costiveness, sometimes diarrhoea, and pains in the 
back and loins. In some cases there are epileptic fits, failure of 
memory, change of temper, or a numbness of the fingers, legs, etc. 

Treatment, — The disease is a peculiarly fatal one. As no mode 
of treatment has yet proved successful, it is well to observe caution 
in prescribing. 

The treatment prescribed for chronic inflammation of the kidneys, 
would perhaps be as safe as any that could at present be proposed. 

Bright's Disease of the Kidneys. — Albuminuria, 

This peculiar disease was first explained to the profession in 1837, 
by Dr. Bright, of England, whose name it took. It consists of a dis- 
order of the kidneys, — probably a congestion and an obstructed cir- 
culation in them, from which arise two most important effects ; first, 
albumen, an essential alimentary constituent of the blood, is secreted 
and passed ofl", in larger or smaller quantities, in the urine; and sec- 
ondly, urea, the worn-out matters in the blood which the kidneys are 
made expressly to carry ofl", is permitted to remain. If the urine of 
a person having Bright's disease be examined, therefore, albumen, 
which should not be there, will be found, and urea, a natural constitu- 
ent,, will be absent. 

Method of Examination. — To discover albumen in urine suspected 
to contain it, place a little in a test tube, and boil it over a spirit 
lamp. If albumen be present only in minute quantity, it may cause 
only a delicate opalescence ; if in larger quantity, it may separate in 
curdy flakes, and fall to the bottom as a more or less abundant white 
precipitate. If very abundant^ the liquid may become nearly solid. 

The albumen is the same as the white of an e^g^ and the boiling has 
the same eflect in whitening and hardening it, as upon that substance. 

38 




298 DISEASES OF THE ABDOMIXAL CAVITY. 

Albumen is sometimes found in the urine in a coagulated state, 
and having the shape of tubes or worms. (Fig. 110.) This is quite 
common in Bright's disease. The deposit seems ^^^^ ^^q^ 

to be made up of fibrous casts of the uriniferous 
tubes of the kidneys. 

Symptoms. — The two unnatural conditions 
mentioned above, give rise to the symptoms of 
Bright's disease. One of them, however, is it- 
self the most constant and characteristic symp- 
tom of the disease, namely, the presence of al- 
bumen. This, too, being one of the nutritive 
construents of the blood, its abstraction thins 
the serous portion of the blood, and causes it to filter out of its vessels 
into the cells, — causing dropsy of the cells, usually called cellular 
dropsy, or anasarca. This general dropsy begins frequently in the 
face, and spreads rapidly over the whole body and limbs. In addi- 
tion to this, there are pains in the back and loins, a gradual failing of 
strength, and a derangement of digestion. The skin becomes dry, 
with a pale and bloodless appearance, and there are frequently thirst, 
nausea, and vomiting. The urine frequently has fat, blood, epithelial 
scales, mucus, blood discs, fibrous casts of the uriniferous tubes, and 
saline sediments ; and is generally lighter by weight than in health, 
and less in quantity, and is apt to be red, brown, or dingy in color. 

The retention of urea in the blood acts as a poison, and causes, 
toward the latter end of the disease, when accumulated in large quan- 
tity, drowsiness, convulsions, and apoplexy. 

A frequent desire to make water, with a shifting back and forth 
of the bowels between costiveness and diarrhoea, are common symp- 
toms. 

Treatment. — The results of treatment in this disease are often un- 
satisfactory. Yet if taken in season, investigated with proper care, 
and treated with due diligence, much may be done for its cure. It is 
one of those harassing complaints, which physicians in family prac- 
tice seldom have the patience to investigate and manage with suffi- 
cient care. 

Let the healthy and active condition of all the vessels of the skin 
be the first object aimed at. This will relieve the laboring and falter- 
ing kidneys of a portion of their burden. The alkaline sponge bath 
with vigorous friction every day, will secure this object. 

In the next place, the skin being put in a working condition, should 
be made to work by some internal diaphoretic, — as the tincture of 
veratrum viride, in doses of from five to ten drops, or the compound 
tincture of Virginia snake-root, in teaspoonful doses. 

The kidney may be still further relieved, especially when there is 
considerable tenderness, and other signs of inflammation, by cupping, 
leeching, mustard poultices, and croton oil. 

The bowels should be regulated by some gentle physic, as cream of 
tartar dissolved in flax-seed tea, or rochelle powders, or epsohi salts, 
the lenitive electuary, or the white liquid physic. In some cases. 



DISEASES OF THE ABDOMINAL CAVITY. 299 

podophyllin anc^eptandrin (40), or the compound powder of jalap 
(41), are useful. 

When there is dropsy of the cells, elaterium may be used as physic 
(31), or the kidney may be jogged by digitalis (130) (129), its effects 
being carefully watched. Cider, freely drank, has been found useful 
in some cases. 

To restore the blood, iron (73) (93) (74) (75) (72) (71) is the essen- 
tial article. AVhen there is considerable debility, some of the vegeta- 
ble bitters, as quinine, quassia, gentian, Colombo, etc., may be used 
daily. 

Coffee, and all indigestible articles of food, as rich pastries, new 
bread, high-seasoned meat, and fats must be avoided, — in a word, 
nothing nmst be taken, either in kind or quantity, which the stomach 
cannot easily digest. 

Diabetes. 

This disease is a kind diarrhoea of the kidneys. The amount of 
urine secreted and discharged is large, sometimes enormous in quan- 
tity, — amounting even to several gallons in twenty-four hours. 
Everything taken into the stomach seems to run off by the kidneys. 
The food and drink being mostly converted into' urine, do but little 
good. The kidneys having got into an exalted state of action, do too 
much^ — just as the mucous membrane of the air tubes does in bron- 
chitis. 

A'atiire of the Trine. — Not only is there too much urine discharged, 
but, instead of being lighter than healthy urine, as in Bright's disease, 
it is heavier, and instead of holding albumen in solution, it contains 
grape sugar, 

T§ Detect Su«*ar. — Put a little of the suspected urine in a test tube, 
— add to it a drop or two of solution of sulphate of copper, which 
will give the fluid a pale blue tint. Now add liquor potassa in excess; 
if sugar be present, this will throw down a pale blue precipitate (hy- 
drated oxide of copper), which will immediately re-dissolve, forming 
a purplish blue liquid. Boil this over a lamp ; if there be sugar, a 
reddish or yellowish-brown precipitate (sub-oxide of copper) will be 
thrown down ; if no sugar, a black precipitate (common oxide of 
copper) will fall to the bottom. 

Another Test. — Place a little urine in a test tube ; add to it half 
its volume of liquor potassa, and boil five minutes. If there be sugar 
present, the liquid will take a brownish or bistre tint. 

Growth of Torula as a Test, — Place a portion of sacharine urine 
in a warm place, and a scum will soon rise, as if a little flour had 
been dusted on it. This, when examined under the microscope, 
proves to be minute oval bodies. These expand and dilate the vesi- 
cle containing them, into the form of a tube. They still continue to 
enlarge, and project from the parent bladder, like buds. The whole 




300 DISEASES OF THE ABDOMINAL CAVITY. 

then resembles a jointed fungoid growth (Fig. 114»), which finally 
breaks up, and falls to the bottom, as a copious deposit of oval vesi- 
cles or spores. 

Other Symptoms, — Great thirst, craving ap- fig.iii. 

petite, dry skin, a sense of weight and uneasi- 
ness in the stomach after eating, dry and parched 
mouth, w^hite and foul or clean and red tongue, 
wasting of flesh, languor and aversion to exer- 
cise, debility, pain and w^eakness in the loins, 
costiveness, loss of the sexual feeling, and cold 
feet. As the disease draws tow^ards a fatal end, 
the gums become spongy, the breath fetid, 
sometimes smelling like urine. 

Treatment. — The skin should have about the same treatment as 
that recommended in Bright's disease. Also, the same counter-irrita- 
tion over the kidnevs. The bowels must be kept open by some gentle 
physic (13) (12) (15). 

Tonics. — These will be required to restore the tone of the system, 
particularly iron, — same preparations as recommended in Bright's 
disease. 

Astring'ents to check the flow of uriiie will be needed. Alum, in 
three-grain doses, three times a day, or sugar of lead, or white vitriol, 
or clear opium, will be serviceable. Creosote, in one or two-drop 
doses, and tincture of cantharides, have each cured cases. 

One scruple of Peruvian bark, one scruple of wild cranberry leaves, 
powdered, and half a grain of opium, mixed and taken three times a 
day, is a good remedy. 

All articles which contain sugar and starch must be forbidden 
in the diet. Bread and potatoes contain a large amount of starch ; 
and beets, parsnips, and some other vegetables, have sugar. It is oest 
to confine the patient almost entirely to tender, fresh meats ; and the 
drink, notwithstanding the great thirst, must be restricted to a very 
small quantity. 

Bleeding from the Kidneys, etc. — Ilcematuria. 

By this I mean a discharge of blood from the urinary passage. It 
may come from the kidneys, the ureters, the bladder, or the urethra. 

Symptoms. — The passage of the blood is preceded by pain in the 
region of the bladder or kidneys, and accompanied by faintness. 
There is generally heat and distress in the loins, and tenderness 
upon pressure in the region of the bladder or kidneys, according to 
the place from which the blood comes. 

It is sometimes difficult to decide whether the coloring matter in 
the urine is really blood. In such cases, the microscope will generally 
detect the blood corpuscles, if present. They commonly appear as in 
Fig. 112, — having a yellow color, and pretty uniform size. 




DISEASES OF THE ABDOMIN^VL CAVITY. 301 

Treatiueiit. — This must of course vary according to the nature of 
the case, and the immediate cause producing it. Where active bleed- 
ing exists, the patient mus-t have absolute rest no. 112. 
in bed, with applications of cold to the hips and 
loins. If the patient be strong and full of blood, 
wet cups or leeches may be applied over the 
kidneys, or the bladder. In such cases, too, the 
bowels must be freely moved with some prepar- 
ation of salts (14) (IS) (20) (25). 

Sugar of lead is a valuable remedy ; but it 
should be given in large doses for a short time, 
rather than in small doses for a long time. It is 
best taken in form of solution (348), two great spoonfuls every two 
hours, until five or six doses are taken. 

But the best remedy is gallic acid. It seems to have extraordinary 
power in this complaint. It should be given in five-grain doses, 
mixed with* a teaspoonfui of mucilage of gum arable, and ten drops 
of tincture of henbane. 

Suppression of Urine. — Ischuria Renalis. 

This disease is, in one respect, just the opposite of diabetes. 
While immense quantities of urine are secreted in that, none is se- 
creted in this. In that, the kidneys do too much ; in this, they do 
nothing. • 

This complaint is sometimes called paralysis of the kidneys. It 
usually occurs in old persons, and those inclined to corpulency. 

SyiiiptoiiiS. — The patient makes no water; and if the catheter be 
api)lied, none will be found in the bladder. The patient feels unwell, 
restless, anxious, with a slight pain in the loins and bowels, perhaps ; 
but on the whole not illness enough to give any very good account 
of it. After a little time, nausea comes on, and perhaps vomiting, 
and soon drowsiness, wanderings of mind, incoherent talk, hiccough, 
stupefaction, and death. These head symptoms are caused by the 
shutting up, in the kidneys, the natural outlet of urea, of an excre- 
mentitious matter, which acts as a poison to the nervous system. 
Before death, the perspiration has a strong smell of urine. 

Treatment. — The cause of this complaint not being known, the 
treatment must necessarily be a little uncertain. We cannot go 
amiss, however, in placing the patient immediately in a warm bath 
for fifteen or twenty minutes. Then apply wet cups over the kidneys, 
and follow these either by mustard poultices, or by hot fomentations. 

Let the bowels be opened by the compound powder of jalap, or by 
elaterium (31). Epsom salts or cream of tartar might in some cases 
be substituted for the above. A stimulating injection is also desira- 
ble (246). 

Diuretics, as sweet spirits of nitre, digitalis, queen of the meadow and 
peach leaves, equal parts, and marshmallow, are of course called for. 



302 DISEASES OF THE ABDO^IIXAL CAVITY. 

m. ■ . 

Much of the poisonous matter retained may be got out through the 
skin, by a free use of the compound tincture of Virginia snake-root 
or tincture of veratrum viride in full doses. 

Although the symptoms, in the earlier stages of this complaint, 
may not attract much attention, or be thought worthy of notice, yet 
the treatment should be prompt and energetic, as a fatal termination 
is sometimes reached in the brief space of forty-eight hours. 

Retention of Urine. 

This disorder is often confounded with suppression of the urine, 
but it is different in every respect. In suppression, the urine is not 
formed by the kidneys ; in retention, it is formed, and, in some cases, 
poured into the bladder, but is retained on account of some inability 
to pass it. 

Ischuria. — This is one of the forms of retention. In this complaint, 
the urine has passed from the kidneys to the bladder, but from some 
cause, generally palsy of the muscles of the bladder, it cannot be 
passed off. In this case, there is no pain, but the stream of water 
flows off with slower and slower pace, — the patient having to stand 
a long time, and make tiresome efforts with the abdominal muscles 
to get the bladder emptied. As the quantity discharged diminishes, 
the desire to urinate grows more urgent. Pressure just above the 
pubes, gives pain, and the bladder feels under the hand like a large 
hard tumor. 

Dvsiiria. — In this form of the complaint, the water is passed to 
some extent, but with pain and heat along the water-pipe. This is 
generally caused by some inflammation along the urethra. 

Strano'urr, — In this, the water is only passed, drop by drop, and 
with great burning, scalding, and tenesmus in the neck of the bladder. 
"When there is considerable inflammation, the skin becomes hot, the 
pulse hard and quick, and the tongue covered with a white fur. 

Causes. — These several forms of the complaint are caused by palsy 
of the bladder, gonorrhoea, inflammation in the neck of the bladder 
or the water-pipe, mechanical injuries of the bladder in child-bearing, 
or otherwise, by tumors pressing upon it, by irritation from gravel or 
stone within its cavity, by stricture or partial closing up of the urethra, 
by disease of the prostate gland, by taking spirits of turpentine or 
cantharides, or by the absorption of this latter article when used as a 
blister. 

Treatment. — It is obviously necessary in this complaint, that treat- 
ment, in order to be of any avail, should be prompt ; for when the 
retention is complete, the bladder will burst in from two to five days, 
and cause the death of the patient. 

The treatment must vary according to the cause of the retention. 

If it be caused by palsy of the bladder, the common flexible cathe- 
ter must be used daily until the muscular fibres recover their lost 



DISEASES OF THE ABDO.AIINAL CAVITY. 303 

power. When much irritation is caused by introducing it, it is better 
not to withdraw it, but to close its external orifice with a small plug, 
which the patient can remove as often as necessary to let off the 
urine. To remove the paralysis, the electro-magnetic machine is 
worth a trial, — the current being passed through the bladder. At 
the same time let the patient take strychnia (85) (86) (83) (95). 
Cantharides, in the form of tincture, or in connection with strychnia 
(291), is often useful. 

If the retention be caused by inflammation of the neck of the blad- 
der, leeches should be applied to the perineum, and three or four drops 
of croton oil may be rubbed on just above the pubes to bring out an 
eruption. Warm fomentations will also be serviceable, and warm 
hip baths. Cooling diuretics, as infusions of marshmallow, cleavers, 
pumpkin seeds, buchu, sweet spirits of nitre, etc., must not be omitted. 

Inability to Hold the Urine. — Enuresis. 

This complaint, generally called incontinence of urine, is quite 
common among children. In some cases the child has no ability to 
hold its water at any time ; but generally it is only passed off invol- 
untarily at night while in bed. In adult life it is less frequently met 
with, except among the old. 

Causes. — Irritation of the roots of the spinal nerves which go to 
the bladder, mechanical injuries of the bladder, palsy of the bladder, 
particularly in old people, debility of the neck of the bladder, a gen- 
eral weakness of the nervous system, worms in the bowels, piles, 
whites, gravel or stones in the bladder, etc. 

Treatiiieiit. — As a general rule, the change of constitution which 
occurs at purberty cures this complaint. But as this does not always 
happen, it is important that parents do everything in their power to 
break it up early, lest it become an affliction for life. 

Children who suffer from this disorder are apt to drink largely. 
This habit should be restrained. But little drink should be allowed, 
whatever the desire for it. Care should be taken that the child make 
water before going to bed, — also that it be roused at a late hour for 
the same purpose. 

The skin should be washed all over, every day, with cool or cold 
water, and vigorously rubbed with a coarse towel. This will cause 
the excess of fluids to pass off through the skin, and lessen the action 
of the kidneys. 

In some instances children urinate in bed through carelessness, — 
being half conscious of what is occurring, but not caring enough to 
rouse themselves. In such cases, they are often cured by some de- 
cided correction, — the impending act of passing w^ater, connecting 
itself in their minds with the correction, and recalling them instantly 
to full consciousness. Of course this mode of relief should be resorted 
to with great judgment and caution. 

When the complaint proceeds from debility or relaxation of the 
neck of the bladder, the compound infusion of trailing arbutus, and 



304 DISEASES OF THE ABDOMINAL CAVITY. 

the isinglass custard found among dietetic preparations, may be used 
freely. The tincture of cantharides, from ten to forty drops to chil- 
dren, may be given, and increased gradually to a hundred, or untU slight 
difficulty is felt in passing the water. Then stop, and give the articles 
mentioned above. Spirits of turpentine is useful to some extent, 
given also in small doses, and continued for some time. 

If the disorder be caused by irritation of the spinal nerves, cold 
water douched upon the back, or croton oil rubbed along the spine, 
or a warm stimulating or irritating plaster upon the lower part of the 
back, will be reouired. The electro-magnetic machine may do well 
in some cases. 

Urinary Deposits.— Gravel.— Stone. 

Unnatural deposits in urine are to be regarded simply as evi- 
dences of changes which disease is making in the body. As such 
they are valuable, — more valuable, in many cases, than any or all 
other symptoms we can study, and most valuable from the ease with 
which they may be investigated. Yet, but very few physicians, com- 
paratively, pay any special attention to them, or make any effort to 
acquire the small amount of knowledge needed for their detection. 

Sources of the Urine. — The urinary secretion has three sources. 
The largest bulk of it comes from the superabundance of drink taken 
into the stomach. This is shown from the free flow of pale urine 
after taking copious drafts of water or other fluids. Such quantities 
of water as are often drank, would embarrass the functions of animal 
life, were it not pumped off by the kidneys. 

A second source of supply for the urinary secretion, is to be found 
in the elements of imperfectly digested food, and also some abnormal 
elements arising from incomplete assimilation. Oxalic acid is a 
specimen of the latter, being sometimes largely excreted, in dyspep- 
sia, soon after a meal. 

The third source of urine is found in those old and worn-out atoms 
of the system, which can serve no further useful purpose in the ani- 
mal economy, and which cannot be got rid of by the lungs or skin. 
It is only, however, one portion of the dead tissue, namely, that which 
is rich in nitrogen, which goes out through the renal strainer, — an- 
other portion, which has a preponderance of inflammable elements, 
carbon, hydrogen, and perhaps sulphur, takes the outward channel 
through the liver, as bile. 

Characteristics of Urine. — Healthy urine has a light amber color, is 
transparent, and has different degrees of density, — its specific gravity 
varying from 1.003 to 1.030. It has an aromatic, violet-like smell, 
and a bitter, disagreeable taste, like salts. 

That which is passed a little time after drinking largely, is pale, 
and has a low specific gravity, varying from 1.003 to 1.009, and is 
called urina potus. That passed soon after the digestion of a full 
meal, is called urina chijli^ or urina cibi; it has a specific gravity from 
1.020 to 1.030. That which is secreted from the bloody and is passed 



DISEASES OF THE ABDOMINAL CAVITY. 



305 



before eating or drinking in the morning, is called urina sanguinis; and 
has a specific gravity from 1.015 to 1.025. This is the best specimen 
of the average density and nature of healthy urine. 

Healthy urine contains urea, uric acid, sulphuric acid, phosphoric 
acid, lime, magnesia, phosphate of soda, etc. It is only when these 
are discovered in excess^ that they indicate disease. 

Exaiiiiiiiltioil of rriiie. — Let a piece of blue litmus paper be first 
dipped in the urine ; if it be acid, the color of the paper will be 
changed to red, or reddish-brown. Should the blue color remain un- 
changed, then use yellow tumeric or reddened litmus paper ; if the 
urine is alkaline, the tumeric will become brown, and the reddened 
litmus will be changed to blue. If the color in both cases remains 
unaltered, the urine is neutral ; that is, neither acid nor alkaline. 

This being done, let the specific gravity be taken. This is easily 
done by the urinomcter (Fig. 113). "This "^instrument is known also 
by the nances hydrometer, and gravimeter. It is generally fig. us. 
made of glass. When placed in distilled water, it will sink 
to a certain point ; and as all bodies immersed in fluid dis- 
place a bulk equal to themselves, it follows that in a fluid 
denser than water, the instrument will not sink so deep. The 
space above the large bulb is marked off into degrees corres- 
ponding to difi'erent densities. When this instrument is im- 
mersed in urine, and has come to rest, the number on the 
graduated sca^, which stands at the surface of the liquid, 
when added to 1000, will represent the specific gravity of the 
fluid. If, for example, the surface of the liquid corresponds 
with 9 on the scale, the specific gravity of the urine will be 
1.009 ; if at 25, it will be 1.025. 

By attending to the specific gravity of the urine, the phy- 
sician may often gain important information respecting his patient, 
as it may be made to show him how much solid matter is daily car- 
ried out of the body through the kidneys. This, at the bed-side, may 
often give useful hints in regard to treatment. 

The following table, constructed by Dr. Golding Bird, shows at a 
glance the amount of solid matter in 1000 grains of urine of different 
densities : 



Specific 
Gravity. 

1001 
1002 
1003 
1004 
1005 
1006 
1007 
1008 
1009 
1010 



Solids. Water. 



Specifac 
Gravity 



Solids. Water. 



2.33 

4.66 

6.99 

9.32 

11.65 

13.98 

16.31 

18.64 

20.97 

23.30 



997.67 
995.34 
993.01 
990.68 
988.35 
986.02 
983.69 
981.36 
979.03 
976.70 



1011 
1012 
1013 
1014 
1015 
1016 
1017 
1018 
1019 
1020 



25.63 
27.96 
30.29 
32.62 
34.95 
37.23 
39.61 
41.94 
44.27 
46.60 



974.37 
972.04 
969.71 
967.38 
965.05 
962.72 
96039 
958.06 
955.73 
953.40 



Specific 
Gravity, 



Solids I Water. 



1021 


48.93 


1022 


51.26 


1023 


53.59 


1024 


55.92 


1025 


58.25 


1026 


60.50 


1027 


62.91 


1028 


65.24 


1029 


67.57 


1030 


69.90 



951.07 
948.74 
946.41 
944.18 
941.75 
939.42 
937.09 
934.76 
932.43 
930.10 



Specific 
Gravity. 



1031 
1032 
1033 
1034 
1035 
1036 
1037 
1038 
103 9> 
1040 



Solids. Water* 



72.23 
74.56 

76.8£^ 
79.^^ 
81.55: 
8;3t.88 i 
&6.21 1 
88.54 
93.87 
93 20 



921.77 
925.44 

S23.n 

920.78 
918.45 
916.12 
913.79 
911.46 
909.13 
906.80 



The mode of using the above table is this. Having learned the 
density of the urine passed in twenty-four hours by means of the 

39 



306 DISEASES OF THE ABDOMINAL CAVITY. 

urinometer (Fig. 113), a glance at the table will show the proportion 
of solid matter and water in 1000 grains of the urine. Then, by- 
weighing the whole quantity of urine passed in twenty-four hours, the 
weight of solids drained off by the kidneys, may be determined by the 
simple rule of proportion. 

Symptoms of Gravel. — A sudden attack of pain in the region of 
the kidneys, so acute and severe, frequently, as to cause fainting, and 
even convulsions. The pain runs down to the groin and "thigh, caus- 
ing a numbness on the affected side, and a drawing up of the testicle. 
The pain is excessive at times, and then remits. Finally it stops sud- 
denly. 

Leading from the kidneys to the bladder are two small tubes about 
the size of a goose-quill, called ureters, — being the appointed chan- 
nels of the urine. The pain, of which I have spoken, is caused, gen- 
erally, by the passage of a stone along one of these small tubes. If 
the stone happen to be a little too large for the tube, or uneven or 
ragged upon its surface so as to bruise and tear the delicate lining 
of the ureter, severe pain is the result. The pain is intense when the 
stone moves along ; remits when it stops ; and suddenly ceases alto- 
gether, when it gets through, and drops into the bladder. 

Sometimes there is no pain, the gravel being so fine as to pass 
through the ureters very easily. It then passes through the urethra 
also, and is found as a sediment of the urine at the bottom of the 
vessel. ^ 

These urinary deposits are various, and quite unlike each other in 
kind. They indicate different states of health, and require to be 
spoken of separately. 

Uric-Acid Gravel. 

This form of deposit passes indifferently under the name of uric 
acid gravel, or lithic acid gravel. The person who is in the habit of 
passing this kind of deposit largely, is said to have the lithic or m-ic 
ficid diathesis or condition. 

Fig. 114. Fig. 115. 





The urine of persons in this state lets fall after it has stood awhile, 
a reddish sediment, like brickdust. This consists chiefly of urate of 
ammonia (Fig. 114 and 115), tinged with certain coloring matters. 



DISEASES OF THE ABDO]\riNAL CAVITY. 



307 




This coloring substance may be more or less abundant, and give to 
the deposit various shades, as dirty-white, yellow, pink, and red. The 
Fia. ne. pure uric acid sometimes appears as fine 

sand, or large crystals (Fig. 116). The 
urine is of a dark copper color, about like 
brown sherry, and is more scanty than in 
health. It is also highly acid, giving to 
litmus paper a deeper shade of red. 

Persons who pass this kind of gravel 
largely, are apt to be troubled with in- 
flammatory complaints ; with acidity of 
stomach and heartburn ; and some of 
them with gout and rheumatism. 

Placed under a blowpipe, uric acid is 
decomposed, and gives out an odor like 
that of burnt feathers, combined with the 
oil of bitter almonds. It is dissolved by 
liquor potassa, from which muriatic and 
nitric acids precipitate it; and by sulphu- 
ric acid, from which it is precipitated by water. Acetic, nitric, and 
muriatic acids, alcohol, ether, and water, do not dissolve it. 

Causes. — Uric acid is the form in which nitrogen and the effete 
compounds which contain it are got out of the body. It is the result 
of the decomposition of the tissues of the body. Its gravelly particles 
are the sands of life daily washed out of us, — reminding us always 
that we are wasting away. Whatever causes the body to waste rap- 
idly, produces it in excess. We find it, therefore, in the urine of 
those who suffer from gout, rheumatism, dyspepsia, fevers, debility 
of the genital organs, straining of the loins, etc., which produce loss 
of flesh. 

Treatment. — The remedies for this uric acid gravel are the alkalies^ 
bicarbonate of potash, bicarbonate of soda and magnesia. The first 
named is generally the best. It may be used in the form of the neu- 
tralizing extract, — especially if there be costiveness. If the bowels 
do not need physic, let the potash be taken in the shape of lye made 
from hard-wood ashes (300). Fluid magnesia is an excellent remedy; 
so is liquor potassa, taken in twenty or thirty -drop doses. The urine 
must be watched, and these remedies discontinued when it becomes 
alkaline. 

At the same time the stomach should be supported by some bitter 
tonic, as the infusion of quassia, gentian, columbo, Peruvian bark, etc. 

Iron is, in many cases, not to be overlooked. If the patient be 
pale and bloodless, some of the preparations of this metal will be 
needed (61) (73) (74). 

Acids must be carefully avoided, both in food and drink. 

The diet must be plain, digestible and nourishing, and quite mod- 
erate in amount. The quality is of less consequence than the quantity. 

Exercise is of great consequence, and must be regular, and, if pos- 
sible, in the open air. 



308 DISEASES OF THE ABDOMINAL CAVITY. 

The skin must receive daily attention in the shape of an alkaline 
sponge bath, with friction. This will throw upon the skin much of 
the labor done by the kidneys. 

Phosphatic Deposits. 

These deposits are indicated by a state of the urine just the oppo- 
site of that which contains the uric acid gravel. They are contained 
in urine which is either alkaline when passed, or becomes so very soon 
by standing. 

As the urine cools, a white sand falls to the bottom, and frequently 
a film forms upon the surface of the water. Looking at this film in 
different lights, you may see in it the several colors of the rainbow. 
Skim off this pellicle, place it upon paper, and let it dry ; and you 
may then see the little shining crystals. This urine quickly grows 
putrid and offensive. Sometimes it smells strongly of ammonia. 
The more phosphates it contains, the sooner it becomes alkaline. 

These deposits are generally the triple phosphates. Healthy urine 
contains the phosphate of magnesia in a state of solution. Under 
some circumstances, the urea of the urine is decomposed in the kid- 
neys, and ammonia is disengaged. This combines with the phosphate 
of magnesia, and forms the triple salt of the phosphate of ammonia 
and magnesia, which is not soluble. 

Symptoms. — A sallow complexion, a languid, spiritless state of 
mind, and an exhausted, debilitated condition of body. The urine is 
pale, rather copious, slightly turbid, has a low specific gravity, and 
smells unhealthy, having sometimes the faint odor of weak broth. 
There is generally derangement of the digestive organs, windy stom- 
ach and bowels, nausea, constipation, or diarrhoea, stools of various 
colors, and sometimes, in diarrhcea, resembling yeast, and an aching 
pain and weakness in the loins. 

Causes. — These deposits are produced by great debility of the 
constitution, by injuries of the spine, dyspepsia, defective assimula- 
tion of food, bad diet, irritation of the neck of the bladder, and or- 
ganic disease of the kidneys. But they are caused more especially by 
ivhatever ivears and exhausts the nervous system^ as heavy cares, de- 
pression of spirits, sedentary habits, great mental exertions, mastur- 
bation, and venereal excesses. 

Treatment. — These* deposits being connected with great debility, 
care must be taken not to make the matter worse by taking active 
purgatives, by extreme fasting, or by any means which will increase 
the weakness. 

On the contrary, the strength must be supported by all the means 
that can be commanded. With this view, the citrate of iron (75) 
may be taken. Morphia combined with iron (80), to allay irritability, 
and impart strength at the same time, may be used. The valerianate 
of iron (93) is excellent for the same purpose. 

Connected with a state of urine just the opposite to that which 



DISEASES OF THE ABDOMINAL CA^aTY. S09 

holds the uric acid deposits, this form of gravel calls for the opposite 
remedies. Instead of the alkalies, the acids are wanted. The nitric 
and muriatic acids, with a vegetable tonic (76), may be used. Opium 
is spoken 'of in high terms, and is thought by some to have great 
power in turning alkaline urine acid. The compound balsam of sul- 
phur is highly spoken of, and the compound infusion of trailing arbu- 
tus is also mentioned with approbation. 

It is all-important to throw off care, and to give the mind a chance 
to rise up with all the elasticity it has. To bring this about, journeys 
and amusements are useful. The society of lively, laughing, witty 
friends will do a great deal to give the spirits a rebound, and the 
whole health an upward movement. Such persons are a blessing to 
the world ; and he who reckons a few of them among his friends will 
live the longer for it. 

The skin should have the benefit of the daily tonic effect of a 
sponge bath, with water at first tepid, and afterwards cool ; and exer- 
cise, out of doors, should be habitual, and connected, as much as pos- 
sible, with objects of pleasure. 

The drinking of hard water is highly injurious; and if none other 
can be had, it should be distilled, and then spread out to the atmos- 
phere, in shallow vessels, that it may recover its pleasant taste by 
reabsorbing air and carbonic acid. 

Oxalic Deposits. 

Oxalate of lime in the urine is the cause of this kind of gravel. 
It appears in the form of dumb-bells, and octahedral crystals. (Figs. 
117, 118, and 119.) 

Fig. 117. Fia. 118. Fig. 119. 




The urine has a specific gravity of 1.015 to 1.025, and is generally 
of a dark amber color, and clear^ and bright ; it is generally acid, 
though occasionally alkaline or neutral. Urea is generally found in 
it, and epithelial cells (Fig. 120). Unlike the uric and phosphatic 
urines, it is quite free from sediments, except, as often happens, there 
is a large amount of tirea in it, in connection with the oxalate of 
lime. 

When the urate of ammonia is combined with the oxalate of lime, 
it often happens that the latter has to be dissolved with a little liquor 
potassa, before the former can be seen with the microscope. 



310 



DISEASES OF THE ABDOMINAL CAVITY 



Fig. 120. 



Symptoms. — Great depression of spirits, excitable state of the ner- 
vous system, painful susceptibility to external impressions, dyspeptic 
symptoms, and disturbances of the liver, a fear 
and dread of consumption, emaciation, inability 
to make exertion, — the smallest exertion caus- 
ing fatigue, — in men a deficient sexual power, 
a pain and weight across the loins, and some 
irritability of the bladder. 




Causes. — These deposits are supposed to re- 
sult, like most other derangements connected 
with loss of flesh, in too great a degree of oxi- 
dation. Vegetables produce oxalic acid by just 
the opposite process, namely, deoxidation. 

Whatever depresses the vital powers, may generate this deposit : 
as mental depression, overwork of the brain, burdensome cares, idle- 
ness of mind or body, masturbation, debaucheries, intemperance, vene- 
real excesses, and injuries of the spine. 

This deposit may also be produced by certain articles of diet, which 
contain the oxalic acid. Among these may be named the rhubarb 
plant, which in summer is largely used for tarts ; and sorrel. 

Treatment. — The treatment for these deposits should be very much 
like that for the phosphatic. The stomach and liver should receive 
some special attention. A pill of leptandrin, podophyllin, etc. (39), 
may be used with advantage. The preparation of nitric and hydro- 
chloric acids (76) must generally be taken for some time. In cases 
of great irritability, the sulphate of zinc (82) does well. 

The diet should be plain, digestible, and nourishing, — all articles 
containing the oxalic acid being rejected, as the rhubarb plant, sorrel, 
tomatoes, onions, etc. 

For the rest, follow the directions for the treatment of phosphatic 
deposits. 

Urate of Ammonia Deposits. 

The urine which contains these deposits is generally pale, and of 
low specific gravity, about 1.012. It becomes opaque on cooling, 
from the deposition of a nearly white urate of ammonia. Instead of 
falUng down readily, this forms ropy masses in the fluid, and looks 
like mucus or pus, or something between the two. Its real nature is 
discovered by applying a little heat, which quickly dissipates it. 

Microscopic Characters. — Place a drop of this turbid urine between 
two slips of glass, and examine it closely with a microscope ; you 
will see myriads of minute globules adhering together in linear 
masses. Now place a drop of the turbid urine in a watch-glass, and 
gently warm it ; as soon as it has become clear, add a drop of hydro- 
chloric acid to it, and when it is cold, examine it with the microscope. 
The muddiness will be gone, and you will now see lozenges, or thick 
cohering prisms of uric aciii (Fig. 121). The explanation of this is, 



DISEASES OF THE ABDOmNAL CAVITY. 



311 



that the hydrochloric acid combines with the ammonia, forming muri- 
ate of ammonia in solution, and liberating the uric acid crystals. 



Fig. 121. 



Fig. 122. 





Urate of soda (Fig. 122) is sometimes found in urine, which has 
similar chemical reactions with urate of ammonia. 

Causes. — These deposits are generally produced by some overeat- 
inor, or deranorement of the skin. 

The treatment is the same as that for uric acid gravel. 



Fig. 123. 



Hippuric Acid Deposits. 

These deposits appear in the healthy urine of the cow and the horse ; 
and also in that of human beings, but in such small quantities as to 
be scarcely appreciable. 

They sometimes, however, appear in unhealthy proportions; but 
they never show themselves as a sediment, until after the addition of 
a stronger acid. The urine containing them is 
generally slightly acid or neutral, — sometimes 
alkaline, — haviiif^f a low specific gravity, from 
1.006 to 1.008. The triple phosphates are often 
found in it. 

To detect these desposits, fill a large watch- 
glass with urine, and evaporate it over a lamp to 
a few drops. Then add to it about half its bulk 
of hydrochloric acid, and set it aside. The 
addition of the acid produces a bright pink 
color, and an odor like new hay. After a few 
if the hippuric acid be present, its peculiar crystals will be 
(Fig. 123.) 




lOurs 
seen. 



Cause. — In man, this deposit is supposed to depend on the ab- 
sence of food having a good share of nitrogen. The urine of vege- 
table eaters contains it in largest quantities. 

Treatment. — The only treatment required is a diet composed in 
good proportion of animal food, a proper attention to the skin by 
bathing, etc., and when debility exists, tonic medicines, as iron and 
bitters, with out-door exercise enough to keep the muscles in working 
order. 



312 DISEASES OF THE ABDOMINAL CAVITY. 



Cystine Deposits. 

These do no occur in healthy urine, and rarely as an element in 
diseased action. They contain twenty-six per cent of sulphur. 

Urine which contains cystine is of a pale yellow color, and has a 
low specific gravity. It frequently has an oily appearance, and its 
smell is peculiar, resembling that of sweet brier. Sometimes its odor 
is fetid, like putrid cabbage. On being kept for a short time, it has 
its surface covered with a pellicle which looks oily, and consists of a 
mixture of crystals of cystine, and the phosphate of ammonia and 
magnesia. 

The cystine deposit appears to be diffused through the urine, which 
is always turbid when boiled. It -is a white or fawn-colored powder, 
and falls to the bottom as a seidment. It undergoes no change by 
warming the urine, and this distinguishes it from white urate of am- 
monia. It is not soluble in diluted hydrochloric or strong acetic acid, 
which distinguishes it again from the earthy phosphates. 

To test this deposit, add liquor ammonia to a portion of it, and 
shake them. If the deposit be cystine, it will dissolve readily. Allow 
a few drops of the solution to evaporate on a slip of glass, and the 
six-sided tables of cystine will remain, which may be examined under 
the microscope. (Fig. 124.) 

Fig. 124. Fig. 125. ' FiQ.126. 




It is to be remembered that occasionally the chloride of sodium or 
common salt crystalizes in octahedral forms (Fig. 125), which, in 
some positions, may look very much like cystine. The ready solu- 
bility of the chloride in water, and the absence of all color when they 
are examined by polarized light, will prevent mistaking these crystal^ 
for cystine. If urine containing common salt be quickly evaporated 
on a slip of glass, and be then examined, instead of the octahedrons, 
we find crosslets and daggers. (Fig. 126.) 

Causes, — An excess of sulphur in the tissues, a scrofulous consti- 
tution, and hereditary predisposition, with defective oxidation, and 
torpidity of the liver. It is often found in the urine of girls who have 
the green sickness. 

Treatment. — The great object is to improve the general health, 
which is to be done by attending to the skin, and the administration 



DISEASES OF THE ABDOMINAL CAVITY. 



313 



of iron and bitters, and also alteratives. The syrup of iodide of iron 
is a valuable remedy. Podophyllin and leptandrin (95) are wanted 
to regulate the liver. The nitro-muriatic acid (76) should be tried. 

The daily sponge bath, and daily exercise, as in most chronic com- 
plaints, must on no account be neglected. 

Stone.— Calculus. 

It often happens that the proper treatment for removing urinary 
deposits is not adopted in season. In such cases, gravelly particles, 
finding a lodgment for a time, in the kidneys or bladder, are apt to 
draw other particles to themselves, which become fastened to them, 
and form a layer quite round them. Over this, other layers form in 
succession, until a stone is produced so large that it cannot pass oft'. 
These grow to various sizes, — being sometimes so large as to fill the 
bladder. 

Uric Acid Calculus. — The most common of these formations is the 
uric acid calculus. It is generally smooth or slightly tuberculated on 
the surface, and varies in color from a pale yellowish-fawn, to a red- 
dish-brown. When sawn through the centre, its layers will be found 
tolerably regular, but of difterent thickness. (Fig. 127.) 

To test it, place a small fragment upon platinum foil under the 
blowpipe. If uric acid, it blackens, and gives out an odor like burnt 
feathers mixed with the oil of bitter almonds. 



Fig. 127. 



Fig. 128, 




Mixed Calculus. — These calculi are frequently composed of two or 
more difterent kinds of matter arranged in irregular layers. Fig. 128 
is a mixed calculus, — the dark layers being oxalate of lime, the light 
ones, uric acid. 

In testing such, fragments of each ingredient should be separately 
examined. 

Urate of Ammonia Calculus. — We occasionally meet with a cal- 
culus composed of the urate of ammonia. These calculi, when found, 
are generally small in size, smooth or slightly tuberculated upon the 
surface (Fig. 129), and of a pale slate or clay color. When heated 
before the blowpipe, it gradually disappears. 

Phosphate of Lime Calculus. — This has a smooth polished surface, 
and quite regular layers, which separate easily when the calculus is 
cut asunder. It has a pale fawn or stone color. (Fig. 130.) 

40 



314 DISEASES OF THE ABDO^ONAL CAVITY. 

It chars before the blowpipe, and gradually becomes white as the 
carbon burns away. Diluted nitric or hydrochloric acid dissolves it 
without effervescence. 

Oxalate of Lime Calculus. — This is frequently met with uncom- 
bined with others, but more generally its nucleus is i:rTic acid or urate 
of lime. It commonly has a brown, dark olive, or dirty-purple color. 
Its surface is irregular and somew^hat rough. It looks like the fruit 
of the mulberry, and is known as the mulberry calculus. (Fig. 131.) 

It dissolves, without effervescence, in diluted nitric or hydrochloric 
acid. When thus dissolved, the addition of a little ammonia will 
cause it to fall to the bottom as a white precipitate. 

Fig. 130. Fig. 131. Fig. 132. 






Fusible Calculus, — This is a mixture of phosphate of lime, and the 
phosphate of ammonia and magnesia. It is the most common of 
all the calculi, except the uric acid. It has an oval, irregular form 
(Fig. 132), and is white, soft, and friable, like chalk. Sometimes it is 
hard. 

It may be known by the readiness with which it melts down before 
the blowpipe, without being consumed. 

Causes. — The causes of the different kinds of gravel have been 
already explained. Generally stones of the bladder are formed in the 
kidney, and descending through the ureters into the bladder, are pre- 
vented from passing out through the water-pi])e by an enlarged pros- 
trate gland. Remaining in the bladder, they soon get encrusted over 
by other matters in the urine, and grow by accretion to be stones. 

Symptoms. — When a stone in the bladder reaches a certain size, 
especially if it is rough, it always produces suffering. A dull, annoy- 
ing pain is felt at the end of the penis. The desire to make water is 
frequent, and there is a sense of weight in the perineum. Sometimes 
the stream of urine is suddenly stopped by the stone falling on the 
orifice of the urethra. As the bladder becomes nearly emptied, it 
embraces the stone, and the pain is increased. Jolting in a carriage 
causes great pain. Mucus passes off with the urine, and sometimes 
blood. After a time, the appetite fails, hectic sets in, albumen ap- 
pears in the urine, and the patient sinks under inflammation of the 
bladder. 

These symptoms being found in diseases of the kidneys and blad- 
der, no one is authorized to pronounce upon the existence of stone, 
until the stone has been touched by a metalic sound introduced into 
the bladder. 



DISEASES OF THE ABDO:\nNAL CAVITY. 



315 



Treatineut. — The only efTectual treatment is a choice between two 
operations, — Uthotrity and lithotomy. 

The former consists in introdncing an instrument, a kind of forceps, 
into the bladder, through the urethra, taking hold of the stone, and 
crushing it. The preparatory treatment consists in correcting the un- 
healthy state of the urine, and the frequent introduction of bougies or 
sounds to enlarge the water-pipe for the easy entrance of the crush- 
ing forceps. The after treatment consists in diluent drinks to increase 
the urine, injections of warm water to wash out tlie fragments, w^ith 
hip baths, soothing injections, and leeches or cupping upon the peri- 
neum. 

Lithotomy consists in making an incision into the bladder through 
the perineum, and taking out the stone or stones whole. 



Dropsy of the Belly. — Ascites, 

This is a collection of water in the cavity of the belly; sometimes 

the fluid is outside of the peritoneum, and next to the muscles. 

• 

Symptoms. — An enlargement of the belly, with a sense of disten- 
sion and weight, — particularly on the side on which the patient lies. 
"When the collection of water is large, the breathing becomes short 
and difficult, and the swelling is uniform over the whole abdomen. 

In some instances the fluctuation of the water may be distinctly 
heard when the patient moves about, — just as we may hear the 
water in a half-filled barrel when it is rolled over. This sound of the 
fluid, when heard, distinguishes the complaint from pregnancy, and 
from the drum-head state of the bowels. This fluctuation may some- 
times be produced by pressing upon one side of the belly while the 
patient is standing or sitting, and striking the other side with the ends 
of the fingers of the other hand. 

In some cases, there is loss of appetite, dry skin, costiveness, scanty 
urine, oppression of the chest, cough, colic pains, and variable pulse. 

Causes. — A frequent cause of this complaint is chronic inflamma- 
tion of the serous membrane which lines the abdomen, — I mean the 
peritoneum. It may also be produced by scarlet fever, fever and 
ague, disease of the heart, particularly dilatation of the right cavities, 
and diseases of the liver, particularly the shrivelled, hobnail condition 
of the liver, — in short, whatever causes a pressure upon the portal 
veins, and obstructs the venous blood returning from the intestines. 

Treatment. — The remedies for this disease are mainly diuretics 
and purgatives. The bowels may sometimes be reduced in a few 
days from an enormous size, by medicines which excite the action of 
the kidneys. Digitalis, combined with acetate of potash, etc. (130), 
forms an excellent preparation. The patient should have as a con- 
stant drink, a strong infusion made from two parts of hair-cap moss, 
and one each of juniper berries and dwarf elder bark ; also an infu- 
sion of queen of the meadow. 

The purgatives used in this complaint are those which produce 



316 DISEASES OF THE ABDOMINAL CAVITY. 

watery stools. One of the best of these is elaterium. It will some- 
times carry off the water with great rapidity ; combined with some 
active cathartics (31), it will have all its good effects without the 
griping it is apt to occasion alone. 

Cream of tartar, taken in large doses, every day, will sometimes do 
well. Epsom salts produces watery stools, and is a good remedy. 

For promoting absorption of the fluid, the iodide of potassium, 
taken in from three to ten-grain doses, three times a day, is a valua- 
ble medicine in many cases. The compound infusion of parsley is 
said to be still better. 

The skin must receive careful attention. The alkaline sponge bath, 
with friction, will increase the transpiration of fluid through that 
organ. Exercise does much to keep up an active circulation, and to 
lessen dropsical effusions. 

The strictest temperance, both in eating and drinking, must be 
observed. A light and nourishing diet, with water, tea, and the 
diuretics named above for drinks ; beyond these the patient must 
not go. 

A kneading and shampooing of the bowels once a day has an ex- 
cellent effect ; it gives activity to the circulation in obstructed veins. 
A bandage tied close around the bowels, and tightened as the water 
diminishes, has an effect upon the sluggish vessels similar to that of 
the laced stocking in varicose veins of the legs. It lessens the liabil- 
ity of a return of the complaint. 

Dropsy of the Cells.— General Dropsy. — Anasarca, 

Just under the skin is a membrane composed chiefly of cells, called 
the cellular membrane. When a considerable part, or the whole of 
these cells are filled with a watery fluid, we call the complaint ana- 
sarca^ or cell dropsy. If, beside this, there is a collection of water in 
the large cavities, we give it the name of general dropsy. 

Symptoms. — The disease generally begins with a swelling around 
the ankle and leg, which is more visible at night after standing and 
walking, and is less perceptible in the morning in consequence of the 
horizontal position of the night. To the touch of another person, 
dropsical feet and legs feel a little colder than natural; and when hard 
pressed with the finger, a pit will be sunk in the flesh, which remains 
some time before it fills up. As the disease advances, the skin of the 
legs becomes smooth, shining, and sometimes even cracks open to let 
out the water. The limbs, and indeed the whole person become stiff, 
heavy, and clumsy. 

As the disease advances, and ascends to the belly and chest, there 
is shortness of breath, a sense of suffocation on moving or lying 
down, a tightness and distress across the epigastrium, thirst, dryness 
of skin, wakefulness, loss of appetite, scanty and deep-colored urine, 
and a slow fever. 

Causes. — General dropsy is caused by whatever weakens the gen- 
eral system, and by such circumstances as obstruct the circulation in 



DISEASES OF THE ABDOMINxVL CAVITY. 317 

the veins. The most frequent causes, therefore, are certain diseases 
of the heart and kidneys. 

Explanation. — Modern physiology has demonstrated that the veins 
do a certain part of the work of absorption. The serous membranes 
which line the larger cavities of the body exhale watery fluid enough, 
and no more than enough, to keep them moist, and cause the organs 
within to play smoothly upon their surface. If the fluid were not 
taken away as fast as it is poured out, the cavity, — being a shut sac, 
— would become full, and we should have dropsy. It is the office of 
the veins to absorb this fluid and convey it away in the general cur- 
rent of the blood. 

This is the method of their doing it: The walls of the veins are 
so constructed as to permit iv at ery fluids to pass through them^ either 
in or out. When they are comparatively empty, or only moderately 
full, fluids on the outside pass in, and mingle with the contents. 
This is called endosmosis. When they are very full, the watery 
portion of the blood will filter through, and pass out. This is called 
exosmosis. 

Now, if the reader will think a little, he will easily see that if the 
veins are barely full enough not to allow any fluid to pass in, the 
natural exhalations of the shut sacs would bring on dropsy ; but if 
the veins are so full as to cause water to flow out, then the dropsical 
accumulation will be still more rapid. 

Such being the oflice and nature of the veins, the reader may 
learn how disease of the right side of the heart will cause dropsy. 
When the right ventricle is so dilated and weakened that it cannot 
send the blood forward to ,the lungs, of course the veins which bring 
it to the right side of the heart, wilt become full, and greatly distended, 
Exosmosis will then occur ; the watery portion of the blood will 
begin to run out, either into the large cavities, or into the cells, and 
dropsy, either general or local, will be the result. 

Treatment. — This must be governed very much by the cause of the 
disease. 

In dropsy from disease of the heart, we may use diuretics and 
such other measures as are recommended for dropsy of the belly. 
If the urine is strongly acid, depositing the brick-dust sediment, 
the alkahne diuretics will be the iDest, as the acetate and bicarbon- 
ate of potash combined, and dissolved in water. The bitartrate of 
potassa, to act upon the bowels, is a proper remedy. If the disease 
arise from general debility, the following powder will be useful : 
digitalin, three grains ; cinchonia, half a dram ; phosphate of iron, 
half a dram ; and white sugar, one dram. Mix, and triturate ; divide 
into sixteen powders, and give one, in pumpkin-seed tea, four times 
a day. 



VENEREAL OR SEXUAL DISEASES. 



Of all the diseases to which flesh is heir, none bring so much 
misery, moral and physical, as those called sexual or venereal. To 
the physician, they are the source of the greatest anxiety and per- 
plexity. They bring him into possession of the most delicate secrets, 
— secrets which involve the peace of families and neighborhoods, — 
secrets which his honor as a man, and his truth as a physician, compel 
him to lock fast in his own breast, and hold sacredly apart even from 
his nearest companions, — secrets which, if revealed, would fill domes- 
tic circles with unutterable bitterness and heartburnings, and whole 
neighborhoods with scandal and immorality. These secrets are often 
a burden to him. They are in his breast like undigested food in the 
stomach, — disturbing the whole nature. 

The patient, if a man of sensibility, suffers even more, of course, 
than his physician. Li many cases, he is a man of virtuous inten- 
tions, and perhaps of religious habits, who has fallen in a moment of 
temptation ; and he fears that the effect of his sin will spread itself 
through his whole system, and extend to the end of life ; or, still 
worse, that having poisoned the fountain of his life, it will go down 
as a heritage of misery to his offspring ; or, what he would deprecate 
as almost equally calamitous, that the partner of his bosom may be- 
come the innocent partaker of his disease. 

Li this state of apprehension, he turns to his physician, not merely 
to keep his secret, but to cure his disease. How great a pity, that in 
such circumstances, he does not always fly immediately to an honor- 
able physician, instead of seeking the advice, as many do, of those 
miserable quacks, who lure him to their dens only to get his money, 
having no intention or ability to cure his complaint. 

These diseases are divided into two great branches, characterized, 
in part, by different symptoms, and generally held to be entirely dif- 
ferent complaints. The first to come under consideration is 

Pox. — Syphilis. 

This disease had a very early origin. It was known among ihe 
Jews, as we learn very clearly from the loth chapter of Leviticus. 
Dr. Adam Clarke's Commentary upon this chapter, at least, makes it 
apparent. David, the king of Israel, has unconsciously left on record, 



VENEREAL OR SEXUAL DISEASES. 319 

ill the XXXVIII Psalm, a most graphic description of Tertiary 
Syphilis, experienced in his own person. Dr. Clarke says : "It is 
most likely the Psalm was written in reference to some severe afflic- 
tion that David had, after his illicit commerce with Bathsheba ; but 
of what nature, we are left to conjecture from the third, fifth, and 
seventh verses." The Psalm is dated not quite a year after the act 
alluded to, — about the right time for the terrible symptoms David 
describes to make their appearance. 

The term syphilis is from a Greek word signifying filthy. There 
is one unvarying sign of this disease, — the existence of an ulcer or 
ulcers, usually upon the genital organs. The French call this ulcer a 
chancre. The common name is simply venereal sore, or ulcer. A 
pimple first appears; on the summit of this a pustule forms; then the 
rupture of the top of this, brings to view^ the ulcer or sore. This ulcer 
is shallow, more or less circular or oval in form, bounded by a perpen- 
dicular and slightly jagged border, and furnished with a smooth, yel- 
low base, nioistened by an unhealthy secretion. The skin around the 
sore is a little thickened and inflamed. This is a simple venereal 
ulcer. It generally lasts about five weeks, and then heals. 

But it is not always thus simple. It may be an inflammatory 
chancre, attended by excessive inflammation. It may be what is 
called a sloughing' chancre^ characterized by the perishing and falling 
off of large parts of flesh. It may be gangrenous^ or marked by a ten- 
dency to mortification. It may be phagedenic^ or eatings — being dis- 
tinguished by a rapid loss of substance, or eating away of flesh. Or, 
finally, it may be indurated^ — being noted for the peculiar hardness 
of the base, and of the flesh immediately around it. 

A venereal sore is the result of impure connection with a person 
having the syphilitic disease. The poisonous secretion of a sore, 
applied to the skin of a healthy person, produces inoculation^ and a 
new sore upon the previously healthy person is the result. This 
chancre appears in a few days after coition, — a certain time being 
required for it to produce its effect, as in the application of vaccine 
matter to the arm. 

Bubo. — The next symptom in the order of occurrence, which fre- 
quently follows the ulcer, is the bubo. It is named from a Greek 
word which means groin, — from its usually appearing in that part. 
It is a painful swelling of the inguinal gland in the groin, and is 
caused by the absorption of virus or poisonous matter from the 
chancre. This gland is one of the lymphatics, a class of vessels as 
numerous, all over the system, as the veins and arteries. They are 
likewise called absorbents. Those that originate from the private 
parts, absorb the poison from a venereal sore, and convey it to the 
glands in the groin, which, being poisoned by it, inflame and swell. 

The bubo generally appears in from one to two weeks from the 
appearance of the ulcer. It is usually upon the same side which the 
chancre occupies upon the penis. When the bubo advances to sup- 
puration, and becomes an open sore, it is then a glandular chancre. 

Vegetations. — These are peculiar growths appearing upon differ- 



320 VENEREAL OR SEXUAL DISEASES. 

ent parts of the skin, which resemble certain vegetables. They are 
found most frequently, in the male, on the head of the penis, and on 
the membrane lining the foreskin. In the female, they are found at 
the entrance to the vagina, and not unfrequently, in the vagina itself. 
They sometimes appear on the neck of the uterus. 

Primarj' Disease. — Thus far, the diseases noticed are what are 
called primary. If properly treated, and cured in season, the consti- 
tution is not infected, and no subsequent troubles appear. But a 
result so fortunate as this, is not common. Generally, the treatment 
is either too long delayed, or is too brief and superficial. The poison 
is, in consequence, absorbed into the circulation ; the whole constitu- 
tion becomes infected ; the fluids and solids are so acted on and 
altered, in fact, that a special constitution is created. For this reason, 
the affections of the skin, the mucous membranes, the bones, etc., 
which follow, are called 

Constitutional. ^ These constitutional diseases never appear imme- 
diately, as the result of an impure connection, but only after those 
affections already noticed. The primary diseases are local ; the con- 
stitutional affections are general. 

The first thing which strikes the eye in these constitutional com- 
plaints, is the color and appearance they give the skin. It has a red- 
dish, coppery tinge, and a peculirly dirty appearance. 

The order in which the several parts are affected, are, first, the skin 
and mucous membranes ; second, the hard substance surrounding the 
bones, called periosteum, the tendons, and the bones themselves. 
Those affections which appear upon the skin and mucous membrane 
are usually called secondary, because they are the second to appear ; 
while those affecting the bones, etc., are denominated tertiary, be- 
cause, in the order of their appearance, they are in the third class. 

Eruptions of the Skin, and Ulcers. — Of the constitutional erup- 
tions, there is a great variety, — so great that I cannot, in small space, 
give a minute description of them. The breast and arms are not 
unfrequently the first to be affected. Attending these eruptions, there 
is little uneasiness, and no pain ; though there is sometimes a slight 
itching. The first breaking out is usually of a copper color, some- 
what paler than it subsequently is. The eruption is often in the 
form of blotches, — elevated only a very little above the skin. They 
are composed of small pustules, with a little fluid in them, which 
soon dries away, and the whole may be rubbed off like bran. This 
may leave the skin looking tolerably sound, and inspire the belief 
that no further mischief is to be experienced. No hope can be more 
delusive. Parts afflicted with this complaint, shoiv no tendency to heal. 
The first crop of pimples is soon followed by a second, which pro- 
duces a thicker crust, and yields a larger amount of bran. This 
rubbed off, small ulcers appear underneath. 

Vesicular Eruptions. — There is another syphilitic affection of the 
skin, which appears in the shape of vesicles, like small-pox. These 
dry and leave a scab. 



PI 




VENEREAL OR SEXUAL DISEASES. 321 

Scaly Eruptions. — There is still another affection, which is in the 
form of scales, and one scale will be piled upon another. It begins 
with an eruption of copper-colored blotches, which become covered 
with scales ; these are succeeded by scabs, and when these fall off, 
shallow ulcers are left with copper-colored edges. (Fig. 133.) This 
is a stubborn form. 

Fig. 133. 




Tnberculnr Eruptions. — In another variety of the disease, broad, 
red, copper-colored tubercles, or hard elevations appear, most com- 
monly about the sides of the nose, or on the cheeks. Gradually, they 
suppurate, and are succeeded by deep ulcers, terminating in scars. 
This is an unfavorable form of the disease, and usually appears some 
considerable time after the primary symptoms, in persons whose con- 
stitution has been shattered. Plate V. 

This rather belongs to the tertiary form of the disease; and in addi- 
tion to the above, patches of unhealthy inflammation are apt to form 
on the tongue, and after a time, break, disclosing ragged, orange- 
colored ulcers. Plate VI. Fig. 2. 

Many other forms of eruption exist ; but in a popular work like 
this, it would be useless to make the nice distinctions which their 
description would require. 

Some of the worst forms of the secondary affections, are found 
upon the mucous membrane of the mouth and throat. These corres- 
pond, in number and kind, with the affections of the skin. They 
affect the lips, the internal sides of the cheeks, the tongue, the tonsils, 
the pharynx, the soft palate, the nasal cavities, etc. They are terribly 
destructive in their effects, — forming gaping ulcers, and eating deeply 
into the parts. They often make shocking work in the whole mouth 
and throat ; and, when attended with considerable inflammation, 
make it almost impossible to swallow anything, or even to open the 
mouth. I have often seen breaches through the palatine arch (Plate 
VI, Fig. 1), and even the whole arch destroyed (Plate VI, Fig. 2). 
Persons have often died from starvation, — not being able to swallow. 
The ulcers sometimes take hold of the tonsils, and " dig them out as 
if it were done with a punch." 

These ulcerations affect the mucous membranes of the genital 
organs. In the female, they often affect the vagina, and the neck of 
the womb (Plate VII, Fig. 2) ; and thus may exist for a long time, 
as the cause of whites, without being suspected as such. They aftect 
also the mucous lining of the fundament and the large bowel. They 
sometimes exist in the ear, and more often in the eye. This latter 
affection passes under the name of syphilitic iritis. In Plate V, 

41 



322 VENEREAL OR SEXUAL DISEASES. 

the artist has well represented this form of constitutional disease in 
the eye. 

The disorder, having, by frightful ulcers, run riot upon the delicate 
structures of the skin and mucous membranes, advances boldly on- 
ward, attacking the muscles, the tendons, the hard covering of the 
bones, and the solid bones themselves. No part of the human frame, 
— not even the skeleton, — can escape this devouring complaint. 
The bones of the nose and face are generally the first to be attacked. 
These perish slowly, — falling away, piece by piece, — the nose, in 
the mean time, sinking down nearer to a level with the cheeks. 
From these parts, the disease may spread to the bones of the whole 
system. 

These affections of the bones, are attended by pains of almost 
every kind and degree. These pains are sometimes fixed in one 
place ; at other times, wandering, — the whole skeleton being painful. 
In these latter cases, they seem to the sufferer to reach the very mar- 
row. Sometimes when the pain is fixed in one place, the feeling is 
such as might be supposed to be experienced if the bone were being 
bored. These pains are most terrible during the night. 

Upon those parts where the skin is near the bone, as the forehead, 
or shin, syphilitic nodes or tumors often appear, which are hard, like 
cancerous tumors. Beside the above, there are the loss of the hair 
(alopecia), blindness, deafness, and various other mischiefs, resulting 
from syphilis which need not be described. 

Is the Constitutional Disease Conuuunicable ? — Many believe, — 
even among those who are eminent in the profession, — that the con- 
stitutional forms of the disease are not communicable. A few years 
ago, indeed, this latter opinion was generally received. It is now 
quite extensively doubted, or rather, disbelieved. Facts are con- 
stantly occurring under the eye of unprejudiced physicians, which 
make it very evident that the constitutional disease may be commu- 
nicated from one person to another. 

The Disease Ilereditaiy. — It is no small amount of suffering, bodily 
and mental, which the individuals endure who contract this disease. 
But the inflictions visited upon them, severe as they are, are small, 
compared with the aggregate of ills entailed by it upon the long line 
of their posterity. Whether it be the man or the woman whom the 
syphilitic virus has inoculated, if it be allowed to be absorbed, so as 
to affect the constitution, it will be very likely to be sent down to the 
children, and children's children. The divine law which links the 
sins of the fathers with the sufferins^s of ev^en the third and fourth 
generation, is nowhere more painfully illustrated than in the scourg- 
ing descent, through many generations, of this terrible disease. It 
may be passed down to posterity by either of the parents ; but if 
both be diseased, its transmission will be the more certain. If the 
mother be infected, she will infect the child while carrying it. If 
the father's constitution be poisoned, the child will recei\'e the infec- 
tion from him, through the semen, and will be likely, while in the 
womb, to infect the mother. I recollect but one author of note 



VENEREAL OR SEXUAL DISEASES. 323 

(Ramsbotham) who has mentioned this mode of infection. I have 
myself seen two cases of it. 

This constitutional disease, whether it exist in the mother, or be 
communicated to the child, and thence to her, by an infected father, 
is a frequent cause of abortion. Throughout nature, blight is the re- 
sult of a diseased parentage. Mature fruit is seldom obtained from 
infected seed. 

Is the Constitutional Disease Curable ? — No question connected 
with the complaint possesses a greater interest than this. None is 
pressed more earnestly upon the physician. In a certain sense the 
disease is curable. Its outward manifestation may be wholly re- 
pressed. The health of the person suffering from it may be restored, 
and become, in an important sense, good. But this cure is never 
brought about by nature ; it may be, and is often effected by medicine. 
I have never failed to effect such a cure in any case which has come 
under my treatment. Such results may properly, in general terms, 
be called cures. 

Yet there is a sense in which a cure never occurs. It is a well- 
attested fact, that a system once thoroughly pervaded by the poison, 
is never completely purged of it. It may be shorn of all its active 
malignancies ; but it has too intimately permeated the tissues and 
solid bones, to be wholly expelled. Pursue it as we will with the 
remedial forces of our art, it still takes refuge in the most subtle pro- 
cesses of animal life, — still infects the currents of being, and finds 
expression in the scrofula, in the lupus, and in the scaly affections of 
other generations. Dr. Erasmus Wilson, the great authority in skin 
diseases, says : " I feel convinced that a considerable proportion of 
those diseases which pass under the name of scrofula, are the produce 
of the syphilitic poison, — are, in fact, not scrofulous, but syphilitic." 
Astruc thought the same, and suggested, what is doubtless true, that 
the transmission of syphilis must occur through several generations 
before it becomes scrofula. Bierchn, Camper, Stoll, Portal, Hufeland, 
and AUbert, have all advocated the same opinion. 

This is doubtless right, though there are many authorities on the 
other side. He must be a poor observer who cannot discover a prob- 
able filial relationship of scrofula to syphilis. 

A variety of facts, admitted by the whole profession, go far towards 
demonstrating this relationship. Scrofula is always hereditary. It 
is a disease of the parent, imparted to the ofispring. But there is 
scarcely any disease so certainly sent down to posterity as syphilis. 

Scrofula is like syphilis in many of its characteristics. It is like it 
in its power of propagating itself from parent to child. It is like it in 
affecting nearly all the children of diseased parents. It is like it in 
the variety of the structures it attacks, — af][ecting the skin, the 
mucous membranes, the bones, etc. Like syphilis it produces hard 
tumors, ulcers of the skin, abscesses, and decaying of the bones. 
And finally, the great remedy for tertiary syphilis, iodide of potas- 
sium, is likewise the great remedy for scrofula ; and, indeed, almost 
every remedy which acts favorably upon one, is found useful for the 



324 VENEREAL OR SEXUAL DISEASES. 

other. This could hardly occur were not the diseases identical in 
nature. 

We can scarcely be surprised that a disease so widely diffused as 
scrofula should be the product of syphilis, when we reflect how fright- 
fully prevalent were the causes of this latter affection during the 
earlier and the middle ages of the world. 

To pass over the records of earlier times, with merely mentioning 
Abraham, and Lot, and Jacob, and Reuben, and Samson, and 
David, and Solomon, and numerous females, of whom some singular 
things are written in the elder scriptures, and omitting all mention 
of the incredible and almost universal debauchery and prostitution 
of Greece, and Rome, and Persia, and Media, and Egypt, I may 
say that Europe^ in the middle ages^ was well-nigh converted into a 
vast brothel. 

Foremost in the race of profligacy, were the priests, bishops, kings, 
and emperors. The licentiousness of Childeric knew no bounds. He 
carried off and violated the wives and daughters of his vassals, with- 
out regard to any right, human or divine. His successors were gen- 
erally a race of lecherous men, who spread debauchery on every hand. 
The French monarchs, from Pepin and Charlemagne, were a race of 
debauchees. Their courts were national brothels, in which the finest 
women in the land were trained in the arts of seduction and lust 
Francis I., in 1515, endeavored to invest prostitution with elegance 
and chivalry, and even to ennoble it, by abandoning the public 
women of the palace to his subaltern officers, and substituting for 
them, ladies of noble blood. In this movement, the nobles and the 
clergy gave the king their support. The right of sleeping with their 
female vassals the first night after marriage was religiously insisted 
on by bishops and abbes, as high barons, and exercised as their privi- 
lege. The inferior clergy were content to haunt the taverns and 
stews, and the monks paid their pimps with the wealth of the church. 
The grand vicar, in some dioceses, sold indulgences to commit adul- 
tery for a year ; in others, a cask of wine paid for the right of forni- 
cation for a lifetime. 

Brantome justifies Francis in his selection of girls of noble blood, 
on the ground that "they could not communicate the venereal dis- 
ease to the noblemen of the courts, like the common prostitutes." 
But the king, who was previously diseased, infected them ; and these 
noble women, so called, passing from the arms of the prince to those 
of the courtiers, presented to them the fatal infection received from 
the king. 

The way in which Francis himself was infected, illustrates, in a 
most shocking manner, the morals of the times. His illicit loves with 
the Belle Ferroniere, were not concealed from her husband, who, 
though obliged, outwardly, to regard the dalliance of his wife with 
the monarch as an honor, was inwardly indignant, and determined 
to become infected himself, and thus disease his wife, and revenge 
himself upon the king. This plan was suggested to him by a monk, 
who had another motive, namely, that of punishing Francis for his 
liberality to the Lutherans. " How," said the husband, when the 



^-EXEREAL OR SEXUAL DISEASES. 325 

suggestion was made, " shall I give this disease to my wife, when we 
are both somid?" " Go visit an infected girl," said the monk, "and to 
render the matter certain, as I am infected, I will see your unfaithful 
wife." The result was such as the husband desired ; and in 1547, 
Francis L, the gay and chivalric monarch, perished of the most foul 
and loathsome of all diseases. 

Debauchery did not die with him. It was cherished by his succes- 
sor, Charles IX., and his mother, Catherine de Medicis, and his grand- 
son, Henry III. The reigns of Henry IV., Louis XHL, Louis XIV., 
the Regency, and of Louis XV., were stained by the same licentious- 
ness and disregard of public decency, until the whirlwind of the revo- 
lution came to purify the moral atmosphere. 

The reader will now, I think, be in no mood to wonder that the 
kings and queens of Europe, and the whole royal progeny, whether 
the dishonored occupants of thrones, or the more private recipients 
of the public bounty, are a scrofulous and degenerating race. Nor 
need it be much wondered at, that so large a portion of men and 
women everywhere have more or less scrofula in their frames. Happy 
are those who can find no trace of this complaint in their constitu- 
tion I They should rise up and call their virtuous progenitors blessed. 
They should especially thank God that they have sprung from the 
loins of a race more noble and kingly in the eyes of Heaven than all 
the royal lines of all Europe. 

Treatment of Syphilis. — In the treatment of this disease, the first 
thing which requires attention is the pimple, pustule, or sore. This 
must be instantly touched with caustic. There should be no delay, 
for if the sore be not syphilitic, the caustic will do no harm ; and if 
it be, the most terrible results may be averted. The general belief is 
that poison remains in the sore for a time before it is absorbed into 
the constitution. It is of the utmost importance that it be destroyed 
before the absorption takes place. 

The caustics used are nitrate of silver (stick nitrate), nitric acid, 
chloride of zinc, potassa with lime, caustic potassa, and the painless 
caustic. 

The nitrate of silver is much used, but the best surgeons now re- 
gard it as useless. It does not prevent the absorption of the poison. 
The caustic potassa, the potassa with lime, and the painless caustic, 
are the sure remedies, — that is, if a'pplied in season. But they must 
be employed with caution. It will not do to trust them in bungling 
hands. A little vinegar and water must be immediately used to neu- 
tralize the caustic when it has accomplished what we desire. After 
the sore is cauterized, a piece of lint, dipped in a solution of watery 
extract of opium, one dram to four ounces, should be laid on it ; and 
the organ inveloped in another piece of lint soaked in tepid water, 
and covered in oiled silk. The patient should remain at rest as much 
as possible, — keeping the penis elevated, and repeating the opium 
dressing to the wound, and the water dressing to the whole organ, 
night and morning. In addition, the patient should take two pills 
(19) to be followed, night and morning, for three or four days, with 



326 VENEREAL OR SEXUAL DISEASES. 

a tablespoonful of (20)^\ In some cases, a piece of lint, wet with the 
tincture of muriate of iron, diluted and kept upon the chancre, will 
cause it to heal kindly, and with safety to the patient. 

If this treatment be adopted early and properly^ the patient is cured, 
and nothing further is needed. But time is generally lost. The poi- 
son is absorbed before the patient is seen by the physician ; and the 
question then is, how it is to be driven out. 

To accomplish this, the diet should be regular and unstimulating ; 
alcoholic drinks and tobacco should be forbidden ; the mind should 
be kept at rest ; a cold or tepid bath should be taken daily; the ac- 
tion of the bowels and kidneys should be kept properly regulated. 
These things will put all the expelling agencies in proper condition 
for work ; and no single medicine will put them all into action like 
mercury. For this reason, no other single drug has enjoyed a repu- 
tation for curing pox so wide as this. 

But it must be used with judgment. No remedy is more safe, if 
judiciously employed, or more destructive, if abused. The profuse 
and ill-considered way in which it was used in former times, raised a 
prejudice against it, which is unreasonably cherished at the present 
day. Abuse made mercury a curse; judicious use makes it a blessing, 
— at least in this disease. 

The blue pill is one of the best forms of it (148), combined with 
extract of henbane. One pill at night is the usual amount to be 
taken. Some prefer the mercury with chalk (149) ; others, the corro- 
sive sublimate (150) ; others, the proto-iodide of mercury (136). Some 
one of these should be given about five days, in the doses named 
under the recipes, — being careful not to produce salivation. After 
the fourth or fifth day, we can generally increase the frequency of the 
dose. Should salivation be accidentally induced, it should be arrested 
by a solution of chlorinated soda (205), one part to twelve of water. 
The mercurial treatment should continue for a week after the sore 
has disappeared ; and in the case of the indurated sore, as long as 
there is any hardness. 

Water should be taken freely, and various diluent drinks. They 
wash the poison out through the millions of avenues, called pores, 
just as we wash filth out of cities by pouring water into the sewers. 

Recently, Ricord, the great French authority on this subject, has 
introduced a new treatment of syphilis by iron. One part of the 
potassio-tartrate of iron is dissolved in six parts of water, and two 
teaspoonfuls are given three times a day. The same solution is ap- 
plied to the external sore or chancre. Ricord says that no secondary 
symptoms have been known to occur after this treatment. The Lon- 
don Lancet sanctions this treatment as being capable of doing all 
that Ricord claims. Should its success prove equally great in this 
country, it will take rank among the greatest gifts to the profession. 
I sincerely hope that in a future edition of this book, a full trial of 
the remedy on this side of the Atlantic will permit me to record such 
success. 

I should mention that there are those who claim to cure the disease 
with other remedies, without mercury, and I am not disposed to be 



VENEREAL OR SEXUAL DISEASES. o27 

dogmatical, and say it cannot be done. For this purpose, pcrhaj)s as 
good a recipe as has been proposed, is the compound syrup of stillin- 
gia, Tincture of poke root, tincture of sheep laurel, each four ounces, 
mixed ; of which, from a teaspoonful to half a tablespoonfnl is to taken 
three times a day. I think well of this remedy, especially if it be in 
connection with a small amount of mercury. 

The Bubo, if not attended with pain, may be treated with compres- 
sion ; by a piece of plaster of ammoniac with mercury ; or by touch- 
ing it with nitrate of silver. Should there be inflammation, and the 
formation of matter be inevitable, the bubo should be opened by 
touching it with the caustic potassa ; and the resulting sore must be 
treated with the solution of opium and water dressing. Should the 
sore need stimulating, it may be touched lightly with nitrate of 
silver. 

Eniptioiis upon the Skin. — In treating the disease after it appears 
upon the skin, etc., we shall derive great advantage from the use of 
either the warm or the vapor bath once a day. With this, if the case 
be not very old, we may employ (148) or (150) ; but if the disease be 
an old one, showing itself in the throat, or attacking the bones of the 
face, we must give iodide of potassium (138), combined with com- 
pound decoction of sarsaparilla. This is the great remedy for tertiary 
syphilis ; but when the case is obstinate, it may sometimes be discon- 
tiiuied, and the corrosive sublimate (139) be substituted for it. 

It is to be observed that the older the disease grows, and the more 
chronic its character, the more does mercury lose its control of it. 
In the first attack, the blue pill is the best ; in the second, as a gen- 
eral thing, the iodide or the biniodide of mercury ; in the third, the 
corrosive sublimate ; in the attacks, subsequent to this, particularly in 
the tertiary form of the disease, the iodide of potassium. "When the 
throat and nose are so ulcerated as to make a case absolutely terrible 
to contemplate, it is surprising to see how rapidly the recovery will 
often take place under the influence of this latter remedy. 

For syphilitic iritis, apply frictions twice a day on the eyelids and 
eyebrows with ointment (172) (173) ; and administer internally two 
pills of (136), daily. 

Case I. — Mr. , aged sixty, was sent to me by his physician, 

from the State of . He had deep and extensive ulcers in the 

upper cavity of the throat, extending to the tonsils, and to the arch 
of the palate. Swallowing had become very diflacult, and much fear 
was felt both by the patient and by his physician, that death would 
follow at no distant day, from absolute inability to swallow at all. 
The ulcers had the peculiar yellow color which so clearly marks these 
sores. I informed him that his disease was tertiary syphilis. He 
said he had once had the disease, many years before, but had sup- 
posed himself cured. The letter brought me from his physician, a 
most respectable man, showed that he also had no suspicion of the 
real nature of the complaint. This case is well represented by Plate 
VI, Fig. 1. 



328 VENEREAL OR SEXUAL DISEASES. 

I put this patient upon a preparation of iodide of potassium, and 
several other articles, which I keep on hand, and syringed his throat 
once a day, with a weak solution of the acid nitrate of mercury (226), 
and in one week, he swallowed his food easily. In three weeks, he 
went home, his throat was nearly well, and his bodily health, which 
had been much shattered, restored. His physician, much astonished 
at his altered condition, wrote immediately to know what I had done 
for him. This patient, though in humble circumstances, has ever 
since, sent me an annual present, which, though not of great value, is 
highly prized by me as evincing a gratitude not forgetful of peculiar 
benefits. 

Ciise II. — In the summer of 1856, a gentleman of distinction came 
to me from a distant state ; and, being so much reduced as to make 
it doubtful whether he would ever reach Boston, he brought his family 
physician with him to render him assistance on the journey in case 
of possible emergency. 

His voice was reduced very nearly to a whisper. I found a breach 
through the palatine arch, and considerable ulceration in the back of 
the pharynx, though not as much as is represented in Plate VL, 
Fig. 1. He was harassed with a cough, and his flesh and strength 
were so far reduced that his high official duties had been for some 
time laid aside. He was supposed by his friends to be verging tow- 
ards the last stages of consumption ; and their consent was gained 
for his journeying to Boston, only because, as they supposed, no hope 
opened to him in any other direction. 

My pronouncing it a case of tertiary syphilis surprised the very 
excellent physician who came with him, and who failed to recognize 
the nature of the complaint only because he had not been accustomed 
to seeing cases of the kind. The disease was of eighteen years stand- 
ing, — being the lingering constitutional result of a case oi gonorrhosa 
(and I have seen several such results of gonorrhoea, whatever Ricord 
may say to the contrary), contracted in a single lapse from virtue in 
early manhood. 

The treatment w^as almost identical with that in Case I., except 
that tonics, — particularly some of the preparations of iron, — were 
required to bring up the strength. The iodide of potassium showed 
its usual specific power, and I had the pleasure to send the patient 
home in a tolerably good state of health. 

Case III. — One of the worst cases I have ever treated was pre- 
sented in the person of Mr. , who came from a considerable dis- 
tance to consult me in reference to a badly ulcerated throat, for which 
all tried remedies had proved useless. The first glance at the throat, 
showed the ulceration to be syphilitic. The uvula and the entire 
palatine arch were gone ; the ulceration had gone deep into the phar- 
ynx. These two circumstances made swallowing extremely difficult ; 
indeed, nothing could be swallowed, except the most bland liquids, 
and death by starvation was near at hand. 

No time was to be lost. I put the patient upon large doses of 



PI. 6. 





.rtrsurfpt cZsZi^ 



VENEREAL OR SEXU^VL DISEASES. 329 

iodide of potassium, with compound infusion of gentian and fluid 
extract of sarsaparilla, and showered the throat every other day with 
a weak solution of acid nitrate of mercury ('226), and in ten days, 
tender beef steak was chewed and swallowed with comfort. 

This patient stayed in Boston six weeks, and went home with ten 
pounds more flesh than he brought with him ; and by using the above 
remedies six months, has regained excellent health. Plate VL, 
Fig. 2, is a representation of this throat as it appeared when it came 
under treatment. 

Fortunately, these cases, terribly destructive as they are, are almost 
always curable, if properly managed. 

Clap. — Gonorrhoea. — Blenorrhagia, 

The reader is aware that the nose, mouth, and lungs, are lined with 
a mucous luembrane, which is liable to become inflamed from various 
causes. -This inflammation we call a cold or catarrh. During its 
continuance, mucus, and other matters of different color and degrees 
of consistency, are more or less freely discharged. 

The mucous membrane of the private parts of both sexes, is just 
like that of the mouth and throat, and subject to similar inflamma- 
tions and discharges. But these inflammations of the private parts, 
instead of being produced by changes of weather, etc., generally result 
from the application of the specific poison of gonorrhoea. When a 
woman abandons herself to unlimited intercourse with different men, 
the private parts become stimulated to so unnatural an extent, that 
the secretions of the parts, w^hich are largely augmented, at length 
become altered in their nature, acrid, and finally poisonous, — so acrid 
and poisonous that they cause inflammation of the parts, and when 
applied to the male organ, in the sexual act, they poison and inflame 
that* 

This is the shortest and plainest explanation I can give of clap. 
From this explanation, one may learn why a man will sometimes 
take a disease from a woman who has never had any evidences of 
being diseased herself. If she have indulged her sexual propensities 
unreasonably, though not enough to produce inflammation upon 
herself, her secretions may yet have become acrid enough to poison 
one whose organs are delicate and sensitive. And more than this. 
The secretions of a female may become acrid and poisonous from 
other causes than excessive venery. The discharges in bad cases of 
whites will sometimes irritate and inflame the male organ, and induce 
a disease which has every appearance of gonorrhoea. A husband, in 
great distress of mind, sometimes submits a case of this sort to the 
physician's inspection, and lays upon him the delicate and responsible 
duty of deciding whether the wife has been unfaithful. No act in a 
whole professional life can be more momentous than a decision of 
this sort. If a man be well skilled in his art, he may give an answer 
in such case, which shall dispel the most terrible apprehensions, and 
save the peace of a loving family.* 

The poison when applied by a diseased person to the male or 

42 



330 VENEREAL OR SEXUAL DISEASES. 

female organs, requires a certain time to produce its peculiar effect, — 
generally from three to eight days. 

Syiiiptoiiis. — The first symptom of the disease is uneasiness in the X 
end of the penis, accompanied, generally, with a little redness, and 
difficulty in passing water. The color of the first discharge may be 
white or straw-colored. There is tenderness where the parts are red. 
Scalding in passing water is sometimes, not always, present at first. 

This is the beginning, or first stage of clap. Now is the time to 
cure it easily. But, unfortunately, the physician seldom sees a case 
in this early stage. Before he is allowed to inspect it, the second 
stage has generally appeared, which is known by violent scalding 
when water is passed, by chordee, or painful erections of the penis, 
and by an increased discharge of greenish matter often tinged with 
blood, and coming from much farther down the urethra, or water- 
passage. The matter sometimes comes from as far down as opposite 
the scrotum, or bag which holds the testicles. There is more or less 
pain in the loins and back. The whole body of the penis may be- 
come affected, and abscesses form. 

A third and more terrible stage of the disease begins when the in- 
flammation has reached the lowest part of the water-passage, just 
where it enters the bladder. Around this part of the passage, and 
lying upon the bladder, is a gland in size and shape like the largest 
chestnut. It is called the prostate gland. On either side of it, lie the 
receptacles of the semen, each of which sends its duct into the water- 
passage. When the inflammation extends through this gland, it irri- 
tates the neck of the bladder, and causes a distressing desire to pass 
water ; and from its proximity to the larger bowel, it sends its irrita- 
tion thither likewise, and impels a terrible effort to evacuate the 
the bowels, called tenesmus. It is the same awful feeling experienced 
in dysentery. Few things can be more terrible than these two dis- 
tressing feelings conjoined, — the desire to pass water and to empty 
the bowels. Racked with terrible pains, and awful tenesmic dis- 
tresses, and often with painful erections, the patient passes back and 
forth between the bed and stool, — often vowing, in the sincerity of 
his heart, that if he can but recover from this, he will never be caught 
again. The enlargement of this prostate gland may become chronic 
and permanent, and be the affliction of a man's life. 

Stricture. — One of the most troublesome and persistent conse- 
quences of gonorrhoea is a partial closing up of the water-pipe, at- 
tended generally by quite a serious obstruction to the passage of the 
water. It is called stricture. The mucous membrane which lines 
this passage, being long inflamed, becomes thickened and less pliable 
or elastic. The tissues which lie underneath this membrane, also 
become swollen and hardened, and, pressing upon the water-passage, 
lessen it still further, — making the stricture more difficult of cure. 

In stricture, the stream of urine is altered in size, length, and force. 
Its course is changed, when the stricture is lateral. The stream is 
often flattened, like the blade of a pen-knife, or twisted like a gimlet, 
or forked, — one stream reaching beyond the other. In consequence 



VENEREAL OR SEXUAL DISEASES. 331 

of obstruction, the bladder is not entirely emptied, and the desire to 
urinate immediately returns, and is very urgent. 

Gleet. — Another very troublesome result of gonorrhoea is gleet, — 
a thin, colorless discharge, which persists, in a chronic form, after dU 
active inflammation has subsided. It is very annoying, and very ob- 
stinate. It is often dependent on the altered condition of the mucous 
membrane occasioned by stricture. 

Orchitis. — Another very severe result of clap is swelling of the 
testicles, called orchitis. It begins frequently with chills and fever, 
with a feeling of weight in the scrotum, and pains in the loins. The 
swelling rapidly increases, and reaches its height in from three to five 
days. 

Beside the above, there 'are still other mischiefs, w^hich follow this 
disease, such as inflammation of the prostate gland, already described, 
of the bladder, and of the kidneys. 

In the female, gonorrhceal inflammation affects the external geni- 
tals called the vulva, the water-pipe, the vagina, and the neck of the 
womb. 

There is a difference of opinion as to whether gonorrhoea ever pro- 
duces secondary or constitutional symptoms. Ricord, the great 
French authority on this subject, affirms, and with him a great num- 
ber of followers, including most of the profession in this country, 
that constitutional symptoms never follow clap ; that they never re- 
sult from anything but a syphilitic ulcer. Vidal, a French authority, 
safer, in my judgment, than Ricord, though not as renowned, says, on 
the contrary, that secondary and tertiary complaints do follow viru- 
lent gonorrhoea. Wilson, the highest English authority, and many 
others, agree with him. Unprejudiced observers feel well convinced 
that this latter opinion is right. I have myself seen not less than 
half a dozen cases of secondary and tertiary syphilis, which were 
preceded by gonorrhoea, and nothing more. Case I. was of this 
kind. 

Treatment. — In the first stage of the disease, there are two meth- 
ods of treatment, either of which may be adopted with success. The 
first, which has many advocates, is the local treatment. An injection, 
with a glass syringe, is immediately made, of a solution of nitrate of 
silver, of the strength of five to ten grains to the ounce of water. It 
should be retained from one to five minutes, by pressing the head of 
the penis between the thumb and finger. If done before the third 
day, this will generally cure the disease. 

The physician should have entire control of the patient, and com- 
pel him, if possible, to keep his room, and live for a few days on 
crackers and water, or something equally simple. All meats and 
stimulating drinks are to be excluded. 

The other mode of treatment, which is perhaps tbe more commonly 
adopted, is more general in its nature. It embraces the use of warm 
baths, warm sweating drinks, and rest. If the patient is full of blood, 
and strong, from five to fifteen leeches are applied to the space be- 
tween the scrotum and fundament. These things, with a low diet, 



332 VENEREAL OR SEXU^U. DISEASES. 

will frequently reduce the disease in a few days. If the discharge 
should continue, after a! fair trial of the above, then copaiba and 
cubebs (272) are to be used. Several articles are added in the above 
prescription, to make the copaiba acceptable to the stomach. This 
preparation can be taken by most persons, and generally produces 
very gratifying results. Vidal strongly recommends an electuary, or 
thick paste (273), of which a piece twice as large as a nutmeg is to 
be taken in the course of the day. The prescriptions which contain 
copaiba and cubebs are numerous ; but the above two are as good as 
a hundred. With these articles, the baths, the leeches, and the repose, 
are to be united. 

Vidal says he never resorts to injections first, but employs the anti- 
inflammatory course first. If that fail, then he uses the injection 
(207), three or four times a day ; and if he employs the nitrate of 
silver at all, it is only as an astringent (208). Prescription (304) is a 
valuable injection. 

When the second stage sets in, and the symptoms become more 
violent, injections must not be used. For the very severe scalding in 
passing water, which is now felt, take thirty drops of a solution of 
potassa in half a tumblerful of water, twice or three times a day. 
Persons of full habit, may be benefited by dissolving a grain or two 
of tartar emetic in a tumbler of water, and taking to the extent of 
producing a little nausea. Relief is occasionally obtained by holding 
the penis for some time in warm water. 

For the painful chordee, or erections, camphor and opium (120) are 
required, — from one to three pills a day. Thirty drops of laudanum 
may be given when the patient retires. Cold applications to the gen- 
ital organs, or walking barefooted upon the cold floor, will frequently 
give relief. When other things fail, three pills a day may be taken 
of extract of hyoscyamus, containing from one to four grains each. 
The quantity of drinks must be diminished, and cold lotions must be 
applied to the penis on going to bed, — the patient covering himself 
lightly. 

Gleet is generally very obstinate, and often requires a very pro- 
tracted treatment. If there be any tenderness along the under side 
of the penis, it is well to apply three or four leeches. Occasionally 
recipe (272) will have an excellent effect. But gleet is an unhealthy 
action, sustained by habit, and may often be cured by simply exciting 
a new action which shall break the old habit. It is always well, 
therefore, to resort to injections. Sugar of lead and sulphate of zinc 
(207) answer a good purpose ; or sulphate of zinc and tannin (209) 
may be tried. Chloride of zinc (210) does well in some obstinate 
cases. 

But gleet is often dependent on stricture^ and when this is the case, 
we must learn the location of it by exploring the water-pipe with a 
bongie. When the instrument reaches the constricted part, the pa- 
tient feels pain, or the surgeon meets an obstruction, — often both. 
When the stricture is found, it is either to have the solid nitrate of 
silver applied to it with an instrument called the parte caustique^ or a 



VENEREAL OR SEXUAL DISEASES. 833 

solution of nitrate of silver (211), or of acid nitrate of mercury (226), 
with a shower syringe which I have had prepared for the purpose. 
When these means fail, we must pass a small bongie gently through 
the stricture ; then a larger, and then a still larger one, until the ob- 
struction be removed. They should be used once or twice a day, and 
not be retained long in the passage. They frequently have to be 
used ten or twelve weeks, and should not be discontinued till the cure 
is complete. Put no confidence in those quacks who promise to cure 
these old troubles in a few days. They want your money, but have 
no expectation or ability to cure you at all. 

For inflammation of the testicles, apply leeches at once. To this 
should be added warm fomentations, and poultices. If these means 
fail, more serious measures are to be adopted, w^hich it would be out 
of place to describe in this book. 

Inflammation of the prostate gland is also to be treated with 
leeches and poultices, — likewise a warm hip-bath. The water must 
be drawn- off with a catheter until it can be passed in the natural 
w^ay. 

Prevention of Seinial Diseases. — I have several times been in doubt 
as to the best method of presenting some of the topics which the wide 
scope of this book has brought before me ; but no one subject has 
perplexed me like the one announced in the above heading, — not 
that it is not easy enough to furnish the rules for preventing venereal 
disease, but that it is a grave question in morals whether to instruct 
the world in the methods of such prevention is right. Is it proper to 
give any other advice than the simple direction to abstain from all 
liability to disease ? That is the question. 

If such advice would be heeded, of course no other should be given. 
But it would not If the person disregarding it would alone suffer 
the penalty of the trangression, it might then be best to embody the 
whole advice in the simple imperative word, abstain! But this can- 
not be. The infection will be imparted to a third person, and onward 
to thousands ; and many of these thousands will be innocent wives, 
who will perish of the disease, or send the infection down to the 
second, the third, the fourth, and to all generations ! While a strict 
morality might seem, therefore, at first view, to forbid the inculcation 
of rules for avoiding infection, the good of the race would appear to 
justify and require it. 

The first requisite for prevention is cleanliness. Frequent washing 
is of prime importance. 

The precautions should not be the same before and after the vene- 
real act, when a person is about to expose himself to risk. Before 
the act, the parts should be carefully examined, to see if there be any 
break in the skin. The least breach in this covering of the penis 
greatly promotes contagion. Before coition, there should be no wash- 
ing with soap, for this deprives the parts of the mucus and oil, — 
thus rendering the naked and exposed skin liable to infection. On 
the contrary, to apply a solution of alum, tannin, or a decoction of 
oak bark, or aromatic wine, constringes or hardens the covering of the 



334 VENEREAL OR SEXUAL DISEASES. 

organ, and renders contagion more difficult. An article called con- 
dom is often used to ward off disease. It is a sack made of gold 
beater's skin, and is drawn over the penis like a glove over the finger, 
and thus protects it from contact with poisonous matter. 

Of still greater importance are prompt measures of prevention 
after the act. Lotions should be immediately applied to every part 
of the organ, and in the case of females, should be used as injections. 
These lotions should be acids or alkalies. A mixture of vinegar and 
water has been recommended as an excellent wash. Record recom- 
mends aromatic wine ; Malapert, corrosive sublimate (212), in the 
form of solution. Probably the best preventive is composed mainly 
of alcohol and soap (213), as recommended by Langlebert. 

An exposed person, using any one of these solutions, particularly 
the last, or, in the absence of all these, washing thoroughly with soap 
and water, will be likely to escape contagion. 

Medical Police. — What is called general prophylaxis, or prevention, 
or medical police, is not a subject of legislation in this country. The 
moral sense of the American people does not admit its necessity. In 
Europe, the authorities watch over prostitution. They even go so 
far as to regulate it. They appoint practitioners, whose duty it is to 
act as a sort of medical police, and particularly to visit houses of 
prostitution once or twice a week, and examine all the inmates. 
When a girl is found diseased, she is immediately removed to a hos- 
pital, and not permitted to return until she is well. 

Self- Pollution. — Masturbation. — Onanism. A 

There is probably no vice to which so many boys and young men, 
and even girls and young women, are addicted, and from which so 
many constitutions break down, as self-pollution. Small boys and 
girls learn the vile practice of the larger ones at school, and generally 
continue it up to maturity, without the least suspicion that they are 
inflicting upon themselves either a moral or a physical injury. 

This comes of the false modesty and bastard morality which with- 
holds from the young all knowledge of the proper functions of their 
sexual organs, and of the inconceivable mischief resulting from their 
abuse. A gentleman of distinction lately said to me : " I instruct my 
boys as faithfully on this subject as upon any other moral or physical 
question, and I tell my wife it is her duty to do the same with the 
girls." This is wise. Yet, how few parents ever speak to their boys 
or girls on the subject, or give them the least reason to suppose there 
is any better rule for their conduct than their own desires I 

Sjinptoms. — These are very numerous. The principal are, head- 
ache, wakefulness, restless nights, indolence, indisposition to study, 
melancholy, despondency, forgetfulness, weakness in the back and 
private organs, a lack of confidence in one's own abilities, cowardice, 
inability to look another full in the face, and, among females, hysterics, 
whites, and a desire for seclusion from society and solitude. 



VENEREAL OR SEXUAL DISEASES. 335 

I have already spoken of the receptacles of semen, lying on each 
side of the prostate gland. From the fore part of these receptacles, 
the semen passes through two ducts, about a finger's breadth in 
length, into the urethra or water-pipe, just in front of the prostate. 
From excessive self-pollution, these ducts become very irritable, and 
aleo debilitated and relaxed, — so much so that they will not retain 
the semen ; and during lascivious dreams, it flows off. These semi- 
nal losses are called " nocturnal emissions." So constant is the drain 
they keep up upon many' young men w^ho have abused themselves 
excessively, that the whole man, mentally, morally, and physically, 
becomes a wreck. There are few objects more pitiable to behold 
than a young man in this condition, — his nervous system feeble, 
tremulous, and broken ; his memory weakened and fading out ; his 
eye unsteady and incapable of looking a friend in the face ; his loins 
and back weakened, giving him the feeble gait of old age; his once 
erect form cowed and bent ; his high sense of manliness all oozed out 
of him ; his mind taking up and dropping the simplest threads of 
thought, losing its way in the plainest paths of reflection, and often 
starting back affrighted at the glimpse of chaotic insanity opening 
before him, — turning here and there for relief, but finding little hope 
of recovery, except in marriage, and yet knowing himself unfitted to 
be the husband of an intelligent woman ! 

Treatment. — Every kind of treatment, no matter how judicious or 
well applied, will be unsuccessful, unless the vice w^hich has produced 
the disease be absolutely and entirely abandoned. This is the first 
thing to be secured. It may be extremely difficult for the patient to 
do this, with his mental and moral nature all broken and in ruins, — 
with no heart to feel, and will to execute ; and yet it must be done, 
or a cure cannot be effected. 

To bring this about, everything must be done by the physician to 
strengthen the moral nature of the patient, and to raise his self-respect 
and hope. The most careful directions must be given for restraining 
the imagination. The patient must be directed and encouraged to 
drive out from the mind, instantly, and upon all occasions, every 
lascivious thought ; to cultivate the society of the most intellect- 
ual and virtuous females ; to make himself busy with useful and, if 
possible, agreeable employment ; to avoid solitude ; and to sleep 
with some friend. He should sleep on a mattress, and never on 
feathers. 

Where there is considerable debility, tonics will be required, as the 
mineral acids (60) (62) (78), and bitters (77) (67) (66) (59), and 
strychnine (83) (95) (85), and iron (80) (93) (72) (73) (71). In addi- 
tion to some of the above preparations, the syrup of the hypophos- 
phites should be taken for some time. 

The food should be nutritious and easy of digestion, and the cold 
alkaline sponge bath should be taken once a day, with brisk rubbing ; 
and the private parts should particularly be washed daily with cold 
water. 

In conclusion, I say emphatically to parents, do not let your sons 



336 VENEREAL OR SEXUAL DISEASES. 

and daughters remain ignorant on this subject. It is plainly your 
duty to enlighten and to warn them. It is a matter in which young 
persons are generally disposed to do right, if rightly instructed. 
Avail yourself of your right to give counsel, and, if need be, to use 
authority. 



FEMALE DISEASES, 



In addition to the diseases common to both sexes, women are 
subject to a class of distressing complaints peculiar to themselves, 
and denominated, in general terms, female diseases. Involving con- 
siderations -of a delicate nature, thes^ complaints have too generally 
and too long been shut out from works intended for popular distribu- 
tion. Hence there is a general ignorance of a class of diseases which 
are fast unfitting woman for the high duty of continuing the race ; 
and the subjects of these maladies are generally themselves so unin- 
formed of the true nature of their sufferings, that they are neither 
prepared to seek relief in the proper direction, or to submit to the 
remedy, if it chance to be proposed. 

It is intended here to speak of these disorders, as I have done of all 
others, in a plain and simple way, to describe them, so far as the 
present state of medicine permits, just as they are, and to make 
known the only modes of treatment which have been found available 
for their cure. The sufferings of woman require this ; the interests 
of humanity require it ; and the writer is impelled to it, as he thinks, 
by a just sense of responsibility. 

Physicians, in my judgment, are chargeable with a great wrong in 
concealing within their own breasts information upon what are called 
delicate subjects, — information which the good of the world requires 
should be divulged, and which they ought to pour into the public 
mind, and make common, and which they would thus popularize, but 
for their stiff pride and conservatism. 

The idea that our knowledge cannot be imparted to the world 
without injuring the public morals, is simply absurd. We are more 
afraid of bringing the common people too near to us, of letting down 
our dignity, and of opening our profound secrects to popular eyes. 
The result is as it should be, that unsophisticated people are apt to 
give physicians a wide berth, and to have nothing to do with them, 
unless necessity compels. Let doctors strip off their reserve, and 
while they remain gentlemen, become likewise companions, impart- 
ing their knowledge freely and familiarly to all, and the public con- 
fidence, now considerably shaken, will be frankly restored to the pro- 
fession. 

It should be the object of a good physician to know all he can, and 
to impart his knowledge to as many as possible. Knowledge is not 

43 



838 FEMALE DISEASES. 



merely power ; it is happiness, it is wisdom, it is health, it is virtue ; 
yes, it is always virtue, except in some rare instances, where the worst 
natures pervert it. No physicians are so much loved as those who 
are frank, and have no concealments. The day for mysterious nods 
of the head, and rollings of the eyes, and shrugs of the shoulder, has 
gone by. Men, and women too, (or those of them who are wise), 
wish to know distinctly what their diseases are, and what is neces- 
sary, not to palliate and prolong, but to cure them. 

Time wlien Female Diseases Begin. — Female complaints begin to 
make their apjxiarance at the period of life called puberty, — the time 
when the girl passes from childhood to womanhood. This is the 
period when menstruation is established, which consists of a discharge 
from the genital organs, composed of blood and mucus, and which 
occurs, when regular, every four weeks. Up to this period, the system 
of reproduction has remained dormant. By the intervention of this 
mysterious function, the young female becomes a new being. The 
heart unfolds itself to new emotions ; the mind assumes a solidity 
before unknown, and even the body acquires beauty from a sudden 
rotundity of form. 

This is the period when the great question of female health is very 
apt to be settled once for all, and for life. The girl who is well 
trained at this time, generally has a foundation laid for health and 
character, which is worth more to her than riches. At no time does 
the mother need so much wisdom and knowledge as now. To es- 
tablish the health and develop the affections of the daughter at this 
critical period, is a sacred trust which she can devolve upon no other 
being ; nor can she meet her responsibilities at this time, unless better 
informed than most mothers are. The general apathy in regard to 
this maternal duty is deplorable. 



False Delicacy. — The refined delicacy which withdraws these sub- 
jects from the public gaze, is commendable, for it casts a beautiful 
charm over society ; but when carried so far as to spread a veil even 
over the eyes of mothers, it is quite unnatural, and leads to the worst 
results ; for in the bad management of girls at this critical period is 
laid the foundation of many of the diseases which shatter the consti- 
tution of so many women. For this bad management, it is not 
mothers alone who are to be blamed. The neglect of the medical 
profession to furnish the necessary information should come in for its 
full share of reproach. 

The Establishment of tlie Menses. — Nature always comes slowly 
and by degrees to the inauguration or establishment of any of her great 
functions. It is so in regard to menstruation, or, as it is variously 
called, "the menses," "the courses," "the change," "the flowers," 
" nature," etc. For some time before the flow begins, there are cer- 
tain symptoms, or premonitions, which, to the eye of the physician, 
plainly enough foretell the impending change. To the mother these 
signs would be equally intelligible, were she as well informed as she 
should be. It is plainly her duty to be intelligent enough to assist 



FEMALE DISEASES. 339 



nature in the establishment of this important function. But how 
often, either from ignorance, or from false ideas of delicacy, does she 
fail to interfere, and allow the daughter to be taken by surprise, and 
perhaps frightened and thrown into convulsions! 

From inquiries made of about one thousand women, a distin- 
guished English physician found that about one quarter were unpre- 
pared for the appearance of the menses. Some of the girls were 
frightened and went into hysterical fits ; others thought they were 
wounded, and washed with cold water. The flow was stopped in 
several cases ; and in some, never restored ; while the health of all 
in whom it was interrupted, was seriously impaired. 

Symptoms of the First Mensti'uation. — A variety of symptoms pre- 
cede and foretell the first menstruation. Headache, dizziness, slug- 
gishness of thought, and disposition to sleep; — these, occurring in a 
girl, may be taken as hints that the " change " is at hand. If to these 
be added pains in the back and lower limbs, the intimations will be 
still more significant. 

At this time a girl loses a relish for the society of children ; she is 
apt to acquire a taste for solitude ; her temper becomes wayward and 
fretful ; her eyes acquire a peculiar lustre ; she becomes a sort of 
mystery to her friends and herself, — not her physical frame only; her 
whole character is changed. She is about stepping into a new life. 
Her emotions, thoughts, anticipations, retrospections, are all new to 
her, and her outward manifestations are new to her friends. An in- 
telligent mother will not fail now to prepare her mind for the impor- 
tant event close at hand. 

The age at which this change takes place, depends very much upon 
a variety of circumstances. It occurs much earlier in warm than in 
cold climates. It is hastened by high living; by the whirl, and bustle^ 
and excitement of city life ; by reading novels which are full of love 
incidents ; by attending balls, theatres, and parties ; and by mingling 
much in the society of gentlemen. 

Early Menstruation not Desirable. — It is a law both in animal and 
vegetable life, that the later the period at which maturity is reached, 
the greater the solidity of the body, and the longer it lives. Girls 
who menstruate early, do so because the body is weakened by climate 
or luxury, and the nervous system unduly developed by excitement ; 
w^hile those who come late to womanhood, have firmer constitutions, 
enjoy better health, and live longer. Those mothers, therefore, com- 
mit great errors, who are anxious and administer "forcing medicines," 
because their daughters do not menstruate at fourteen or fifteen. If 
girls are suffering from no special ill health, no anxiety need be felt if 
"the custom of women" do not come to them till the age of eighteen, 
or even twenty. The delay should excite thankfulness rather thai? 
regret. It shows that the constitution has not in it the seeds of earl 
dissolution ; that it is fortifying itself against future disease. 

Girls who come thus tardily to maturity, are much more " regular '" 
in after life. They bear children with fewer accidents, and are af- 



340 FEMALE DISEASES. 



flictcd much less with female diseases. The duty of mothers is plain; 
it is to bring their daughters forward as late as possible, by refusing 
their early admission to society, by withdrawing from them all excit- 
ing reading, by prohibiting their early attendance at concerts and 
theatrical entertainments, by prescribing for them the most unstimu- 
lating diet, and by requiring a large amount of exercise in the open 
air. 

A wide investigation has shown that the first menstruation occurs, 
in hot climates, at the average age of thirteen years and nineteen 
hundredths ; in temperate regions, at fourteen years and seventy-four 
hundredths ; in cold latitudes, at sixteen years and fifty-three hun- 
dredths. Under the hot-house culture of modern society, and espec- 
ially among the wealthy classes, where indolence, luxury, and excite- 
ment, unite to weaken the constitution, this change is constantly 
occurring at a more tender age. 

How Female Diseases are Indnced. — All living things have their 
origin in germs. The germ from which the higher animals spring, 
man included, is an ovum^ or egg. Every animal and every vegetable 
is produced with an organ for the production of germs. In woman, 
this organ is called ovary. There are tw^o ovaries, about half an inch 
in length, — one lying on each side of the womb, to which they are 
attached by ligaments, or cords. The ovarian bodies contain vast 
numbers of vesicles, or cells, or eggs, which are the true germs of 
human life, and the only sources from which it can spring. 

Between the ages of fourteen and forty-five (speaking fn general 
terms), every healthy woman matures and deposits an ovum once in 
twenty-eight days. This vesicle, some time before the monthly flow, 
begins to germinate and swell, and after a time, like a grain of wheat 
in the earth, it bursts its covering, and springs forth. It then passes 
through what is called the fallopian tube into the womb, whence it is 
cast off. 

During the swelling and bursting of this vesicle or germ, the ves- 
sels of the ovaries, and womb, and, particularly, of the membrane 
lining the womb and its neck, are so crowded \/ith blood as to pro- 
duce in the parts a state of congestion. If the parts be examined 
with a speculum at this time, they will be found red, sensitive, and 
almost inflamed. So great is this congestion, that the woman often 
complains of pain in the ovaries and the womb, — and a general 
sense of heat, aching, and dragging down in the lower part of the 
bowels. The pain often extends to the back, the groins, and the 
thighs. 

Tliis Condition Repeated Every Month. — When we consider that 
this state of things is repeated every four weeks, and that the con- 
gested or crowded state of the vessels begins some days before the 
monthly flow, and lasts, in all, some ten days, making about one third 
part of every month, we need not wonder that inflammation so often 
supervenes, with all its attendant ill health and sufferings. 

Increased by Various Causes. — If we reflect, further, that this con- 



FEMALE DISEASES. 341 



gestion is increased, among tlie wealthy, by high living, and, among 
all classes, by over-stimulation of the nervous system, and by the las- 
civious morals of the age, we see stronger reasons for expecting, — 
what is really occurring, — a continually increasing amount of suffer- 
ing from female diseases. 

And when we know, still further, that American females are care- 
less of their health ; that they often attend balls and theatres at the 
very time of suffering from this monthly affliction ; that they fre- 
quently wet their feet, and otherwise expose themselves to colds, we 
cannot feel surprise, even when we learn that from one-half to three- 
fourths of all women in cities, and quite a large proportion of them 
in the country, have inflammation of the ovaries, or of the womb, or 
of the neck of the womb, or suffer some of the forms of displace- 
ment of this latter organ. 

Child Bearing. — The inflammatory state of the uterine organs is 
often induced by injuries received in child-bearing, and by excessive 
indulgence in sexual pleasures. 

Weakness of the Sexual System. — The womb, moreover, like any 
other organ, may be naturally frail, and easily affected by disease. 
This weakness of the sexual system is indicated by the difficulty 
with which menstruation, is established, and the presence of the 
whites, both before and after each monthly flow. Women in whom 
the generative organs are weak, are much more liable to inflamma- 
tion of the womb, and to all the complaints peculiar to the sex. 

Fio. 134. 




Description of the Sexual Organs. — Before describing the particu- 
lar diseases to which the female generative organs are liable, it is 
proper to give the reader a brief description of the chief of these 
organs. 

The Womb itself, in its healthy, natural state, is about two inches 
long, and one inch broad, — weighing a little more than an ounce ; 
and is in shape like a pear. It is lined with a mere rudimentary 
mucous membrane. 

The Neck of the Womb has a cavity distinct from that of the body 
of the organ, and is lined with a mucous membrane well supplied 
with follicles or glands. 



^42 FEMALE DISEASES. 



The Fallopian Tubes open, one from each side of the base, or largest 
end of the womb, and extend outsvard to the ovaries. 

The Ovaries are a bundle of eggs lying one on each side of the 
base of the womb. They are more particularly explained else- 
where. 

Fig. 134 gives some idea of these organs. A, is the body of the 
w^omb ; B, the neck of the womb ; C, C, the vagina ; D, one of the 
ovaries ; F, F, the fallopian tubes ; E, E, the fimbriated extremi- 
ties ; G, the small ligament attaching the fimbriated extremity to the 
ovary. 

Iiiflammation of the \eck of the Womb. — Inflammation of the 
body of the womb is a comparatively rare disease, but inflammation 
of the neck of this organ is so common that in nearly nineteen oat 
of twenty cases, when females seek relief for whites, for painful men- 
struation, for stoppage of the menses, or even for what they suppose to 
be falling of the womb, a careful examination will show that this 
pendent portion of the womb is in a state of marked inflammation, 
or of absolute ulceration. The whites, if they continue, without in- 
termission, from one menstrual flow to another, are almost always the 
result of one of these conditions of the uterine neck. 

It would surprise most persons, out of the medical profession, and 
many physicians, to know how large a proportion of the more grave 
diseases which inflict such terrible suffering upon woman, and so 
completely shatter her constitution, are dependent for their exist- 
ence upon a simple local inflammation, either in the neck of the 
uterus, or in one or both of the ovaries. Many a female has for 
years suffered agonies greater than those of death itself, arising, as 
she supposed, from a complication of ills which invade every part of 
the system, while the whole of her troubles arose, in fact, from an 
inflamed spot which could be covered by the ball of the finger. 

Difficulties of Studying Uterine Diseases. — The facts stated above 
have been but a short time known to medical men ; and to large 
numbers of the profession, are still unknown. The reason is, that 
very serious obstacles have stood in the way of studying the diseases 
of women. 

The social relations of the sexes, and the great delicacy of the 
matters to be investigated, were long the cause of inquiries and ex- 
aminations so indirect that little knowledge was gained, and as little 
benefit conferred. 

Woman, always distinguished for her modesty, could not be ex- 
pected to invite investigations which were not proffered, whatever the 
extremity of her sufferings ; and man, scrupulously sensitive lest he 
should make himself an intruder by stepping within delicate inclos- 
ures, have both, in times past, mistaken their duty by misinterpreting 
the demands of the highest dehcacy. 

\eedful Examinations not Indelicate. — Rightly viewed, no inqui- 
ries or examinations are indelicate which are necessary to a full un- 
derstanding of the nature of disease, and which are niade with the 



FEMALE DISEASES. 343 



sole purpose of rendering its cure possible. I agree with Dr. Meigs, 
the elder, that the delicacy or indelicacy of examining the persons of 
females for the purpose of exploring disease, depends on the motive 
Avith which it is done. To pure-minded persons, it is never, I think, a 
source of impurity. On the contrary, the self-restraint, the honorable 
feeling, and the nice sense of delicacy which it calls into exercise, 
often heighten the tone of a man's virtue, and certainly increase a true 
woman's respect for it. Unfortunately there is now and then a gross- 
minded man in the profession, who, in these investigations, will vio- 
late the most sacred of all trusts committed to his hands ; but such 
monsters, — few in number, — soon find their level, and are shunned 
as the most vile of the race. 

It is now so well understood that these investigations do not lead 
to immoralities, that the most highly educated, intelligent, refined, 
and virtuous females, almost invariably raise the fewest objections to 
such examinations as a physician of character may propose. 

Methods of Investioatiu^ Female Diseases. — The symptoms of 
these complaints will be spoken of in their proper place, as the 
several diseases come under a brief review. I merely wish to allude 
here to the methods of physical exploration which modern practice 
has called to its aid. 

The Touch, — These methods consist, first, of what is called the 
touchy which is made either externally upon the bowels, or inter- 
nally, with the index finger, through the vagina, or passage from the 
external genital organs to the neck of the womb. 

The Speculiuii. — In the second place, of ocular inspection of the 
vagina and neck of the uterus, through an instrument called the spec- 
nluvi. By this instrument, the eye, as well as the finger, is made to 
assist in learning the real condition of the parts. 

The finger informs us whether there is any deviation from nature 
in the bulk, the firmness, the smoothness, or the sensibility of the 
parts ; while the sights through the speculum, affords absolute cer- 
tainty as to whether the parts are suffering from inflammation, ulcer- 
ation, abrasion, or eruption. The following is the best form of spec- 
ulum yet used * 

FiQ. 135 




The end is so shaped as to catch the neck of the w^omb, and then 
by drawing the instrument forward slightly, the diseased surface is 
presented for as perfect inspection as if located externally. 



344 fe:male diseases. 



Inflammation, Ulceration, and Enlargement of the 

Neck of the Womb. 

Inflammation of the neck of the uterus is very common ; ulcera- 
tion and permanent enlargement (technically called hypertrophy), are 
its results, when it is not arrested in due time. These affections, in 
fact, and the same troubles as they affect the ovaries, make up the 
bulk of female diseases, — being the real causes of the most of those 
symptoms which have passed under the name of whites, suppression, 
painful menstruation, sterility, general debility, etc. 

The neck of the womb, when healthy, is soft and smooth. No 
hardness or condensation of tissue can be felt by the finger, on press- 
ing over it. It is elastic, too, and feels unctuous to the touch. This 
latter sensation is communicated by the layer of mucus which covers 
it. Pressure upon it produces no pain. Plate VIL, Fig. 1, is a 
fine specimen of the size, shape, color, and appearance of a healthy 
womb. 

Inflammation, when found in this part, may begin in the mucous 
membrane which covers the neck, or in that which lines its cavity, or 
in the small glands in the body of the organ. 

Symptoms. — Inflammation of the mucous membrane covering the 
neck of the uterus, destroys the unctuous feel which it has in health. 
It also causes the neck to swell, its vessels being crowded full of 
blood. If the body of the organ, as well as the surface, be reached 
by the inflammation, it will be hardened, as well as enlarged ; and in 
consequence of its increased weight, it is apt to drop down somewhat 
into the cavity of the vagina. In married ladies, it is often, by physi- 
cal pressure, pushed a little backward, or retroverted. Examination 
with the speculum, shows the inflamed neck to be of a vivid red, 
instead of a pale rose-color. It may be covered with red or white 
pimples, which are glands enlarged with muco-pus. 

In the healthy state, the mouth of the womb is so much closed as 
to be just perceptible when the finger passes over it. Inflammation 
causes it to be more or less open, and its lips to be parted. 

Inflammation Followed by Ulceration. — In a majority of cases, in- » 
flammation of the neck of the womb and of its cavity, is soon fol- 
lowed by ulceration, which generally appears first around the mouth, 
and just within the cavity of the neck. From thence it spreads both 
inward and outward. Plate VIL, Fig. 3, furnishes a good speci- 
men. 

Various Degrees of Ulceration, etc. — Of course these inflamma- 
tions and ulcerations mix and run into each other in all possible 
forms, — presenting excoriations, or raw places ; granulations, or pim- 
ply surfaces ; and indurations, or hardened parts. Sometimes these 
pimply patches will be red and hard, and again the whole surface will 
be spongy, and will bleed upon the slightest touch. 

In many cases, these ulcerations make ^\Tetched work with the 



FEMALE DISEASES. 845 



mouth of the womb, eating deeply into the cavity, and giving it a 
ragged and unsightly appearance. Plate VIL, Fig. 4, may be taken 
as a sample. 

Telrety Feel from Ulceration. — Ulceration generally gives to the 
surface on which it exists, a soft, velvety feel, which the finger gener- 
ally recognizes. This velvety sensation, with the open state of the 
mouth, are the most important evidences we can derive from the 
touch, of this form of disease. 

The Discharge from these Ulcers is always Pus, or, in common 
language, matter. It is sometimes poured out scantily, at other times, 
very freely. It may be thick and yellow, or thin, and of a lighter 
color. 

The inflammatory and ulcerated condition of the neck of the 
womb, often gives rise to pain ; and when the seat of the disease has 
not been examined, as it should be, this pain has frequently been 
called neuralgia. In this way, ignorance has compelled neuralgia to 
stand sponsor for a great many pains with which it has had nothing 
to do. 

These Ulcers Distarb Menstruation. — Menstruation is generally 
changed, more or less, in its character, by the presence of inflamma- 
tion or ulceration in the neck of the womb. It usually becomes more 
painful. In some cases it is made more profuse^ in others more scanty. 
It may come on more frequently, or it may be postponed, protracted, 
or abridged in its continuance. There is generally pain of a dull, 
aching kind, low down in the back. There is often a feeling of ful- 
ness, pain, and a sense of bearing down in the lower part of the 
bowels ; sometimes the pain extends to the groins and thighs. 

Extensive Disturbances from these Inflammations, etc. — The nerves, 
with which the womb is liberally supplied, belong to those of the 
sympathetic system. Hence, the condition of the uterus influences a 
wide circle of sympathies. By these nerves this organ is brought into 
close relationship with the organs of animal life. If the former suf- 
fer, the latter suffers also. The stomach, being intimately connected 
with the womb, physically, feels keenly these inflammations and 
ulcerations of the uterine neck. At times, the pain, debility, general 
disturbance, and dyspeptic state of the stomach are such as to cheat 
both the doctor and the patient into the belief that this organ is the 
seat of the disease. But in such cases, the symptoms of stomach 
dfsease wiU all disappear the moment the local affection is removed 
from the neck of the womb. 

The liver, too, often participates in these troubles, and becomes 
sadly deranged. It is sometimes even greatly enlarged and congested, 
and patients frequently have the various symptoms of what are called 
liver complaints. 

Severe pains are sometimes felt under the breast bone, and over 
the chest generally, making the patient apprehensive of disease of 
the lungs ; and indeed consumption is not a very unfrequent result of 
uterine diseases. 

44 



346 FEMALE DISEASES. 



Pains are often felt in the region of the heart, which organ is often 
harassed with palpitations. 

The flesh is apt to waste under the symptoms excited by these in- 
flammatory and ulcerative processes in the uterine neck ; and even 
the brain, though lying in some measure beyond the circle of influ- 
ences set in motion by the organic nerves, suffers disturbance and 
pain. 

Even the special senses of sight and hearing may be drawn into 
this general vortex, and both be much impaired. And to crown this 
catalogue of ills, it may be mentioned that those distressing things 
called hysterical fits, proceed from the same local disorders. 

In brief, there is scarce a point in the human body to which these 
inflammatory and ulcerative conditions of the uterine neck may not 
send their sympathetic pains and aches, and where they may not in 
time induce real disease. This is the reason why so many women 
suflering from these local complaints, tell the phyiscian, when consult- 
ing him, that they are " diseased all overT If asked where the com- 
plaint is located, they will answer ■ — " It is everywhere^ In the most 
earnest manner the assurance will be given — ^^ Doctor, there isnH any 
well part about meP 

Treatment. — It is just as unreasonable and useless to treat these 
inflammations and ulcerations through the stomach, as it is an in- 
flamed or ulcerated throat. They are local diseases, affecting' a par- 
ticular part, and the remedy must be local. 

Like all other affections, these can only be managed intelligently 
after their nature is well understood. Nothing can really be done to- 
wards a cure, until it is known what the matter is ; and no competent 
physician will move a single step in the treatment of one of these 
cases, until he has made a thorough examination. He owes this to 
himself and to his patient, — the more so as the neck of the womb 
may be as easily examined as the upper part of the throat, and the 
local remedy may be almost as readily applied in the former case as 
in the latter. 

If, upon the introduction of the speculum, the uterine neck be found 
simply inflamed and enlarged, the application of a strong solution of 
nitrate of silver, once in five or six days, will often prove sufficient to 
reduce both the inflammation and the swelling. If it should not, the 
solid stick should be lightly applied. If this should not succeed 
(though it will in most cases) then introduce a speculum, and when 
the neck of the womb is fairly lodged in its extremity, drop in two or 
three leeches and allow them to fill. 

If ulceration be present, the solid nitrate of silver must be applied to 
the ulcer once in five days. One who is not accustomed to treat these 
affections in this simple way, will at first be surprised at the rapidity 
with which the local trouble will disappear, and with it, the thousand 
and one aches and pains which torment the whole body. As the 
terrible pains in the whole face and head, which are produced by a 
single tooth, all instantly come to an end when the tooth is extracted, 
so do the bad feelings all over the body subside as fast as the local 



FEMALE DISEASES. 347 



ailments of the uterine neck are cured. There is no exception to this 
rule, except where the sympathetic affection has become fixed by long 
neglect of the primary uterine disease. It is, therefore, surprising 
that so many excellent women, whose lives are of the greatest value 
to themselves and friends, should be permitted to perish of these ail- 
ments, when the cure is so simple, and many times so entirely within 
the reach of the most ordinary skill. It is a reproach to the profes- 
sion which should be wiped away. 

If there are a hundred motives for gaining the mastery over other 
diseases, there are a thousand for learning to control these. More 
than any other disease, or all others, they make the homes of men 
desolate, by robbing them of woman, their ornament and solace. The 
physician who neglects to make himself acquainted with all there is 
to be known of these complaints, shows himself not only unfit for his 
profession, but deficient in some of the prime elements which combine 
to make a true man. 

Ilardeiiino^ of the Tterine Neck. — In many cases the uterine neck 
is not only inflamed and enlarged, it is indurated and hardened. At 
times, it is enlarged and hardened on one side, and not much on the 
other. In still other cases, there are enlarged spots, or nodes, giving 
the whole neck a hiotty feel under the finger. 

These hardened conditions of the uterine neck proceed from vari- 
ous causes, and are more difficult to cure than the ordinary inflam- 
mation, or even ulceration. They sometimes indicate cancerous dis- 
ease, and then, of course, involve the most serious considerations. In 
many of these cases, nitrate of silver fails to produce its usual effects. 
We then have to resort to the acid nitrate of mercury, or, as it is 
often called, Bennet's Caustic. No definite rules can be given as to 
the extent to which this article should be reduced. It is sometimes 
applied very strong, and immediately neutralized by the application 
of water. 

rterine SjTinge. — For applying the several remedies to the inter- 
nal cavity of the uterine neck, I have contrived a silver syringe, which 
is bent a little at the extremity, and pierced with fine holes all round. 
With this instrument, the remedy is carried directly to the diseased 
part, and applied instantaneously to every side of the cavity. 

Beside these local applications, it is frequently necessary to resort 
to soothing or astringent injections into the vagina, hip baths, and 
injections into the bowels, some mild physic, and rest in a horizontal 
position. These matters will all be judiciously regulated by the at- 
tending physician, if he is master of his business. 

Case I. — Mrs. F. applied for relief from incessant bearing down, 
pains in the back and hips, pressure upon the top of the head, palpi- 
tation of the heart, bad appetite, the whites, and a brick-colored de- 
posit in the urine, after standing a time. 

I made an examination, and found the neck of the womb enlarged 
and ulcerated, as in Plate VIL, Fig. 4. 

There was no doubt as to the treatment required. I applied the 



348 FEMALE DISEASES. 



solid nitrate of silver to the ulcerated surface once in five days, for 
three months, — at the same time, building up the health, which was 
much broken, by iron and other tonics (75) (63), by a generous diet, 
and by gentle exercise in a carriage. 

The appetite and general health came back, the whites and pains 
all disappeared, and the patient felt, as she said, '.' like a new being.'* 

Case II. — Mrs. C, the mother of two children, had suffered, since 
the birth of the second child, great pain low down in the back, with 
bearing down, and a distressing desire, a good part of the time, to 
pass water. She had a continual discharge from the vagina, of a 
cream-like matter, which very much reduced her strength. Beside 
these symptoms she had pains everywhere, particularly in the head. 

An examination revealed that the neck of the womb was much 
enlarged and hardened^ and badly ulcerated about the mouth. (See 
Plate VIL, Fig. 3.) 

Once in six days, the solid nitrate of silver was applied to the 
ulcerated surface. This was done five times, which caused the ulcer 
to heal, but did not reduce the size of the neck, or diminish its hard- 
ness. 

To effect these objects, I touched the whole hardened surface with 
acid nitrate of mercury, and immediately pressed upon the cauterized 
surface a sponge saturated with water. I repeated this twice, that 
the acid might not penetrate too deep. These operations were re- 
peated once a week, for six weeks, — thirty-drop doses of syrup of 
iodide of iron being given, in the mean time, three times a day, with 
a vegetable bitter and mineral acid (63). At the end of this time, the 
hardness had given way, and the uterine neck was brought down to 
near its ordinary size. The other symptoms disappeared, and the 
patient has had no return of her sufferings. 

Inflammation, etc., of the Ovaries. — Ovaritis, 

The inflamed condition of the ovaries is indicated by increased 
heat, and pain upon pressure. The pain in the ovarian region is 
sometimes intermittent, sometimes constant, and occasionally passes 
down to the loins and thighs. 

There are acute and chronic inflammations of the organs ; but it 
will be sufficiently accurate, in a work of this kind, to treat of them 
as essentially one. 

The effects of inflammation upon the ovaries, as upon t)ther bodies, 
are various, sometimes enlarging and hardening, at other times, col- 
lapsing and blasting them. This last effect, it is hardly necessary to 
say, cuts off all hope of bearing children. 

The Causes of ovarian inflammation are numerous. One of the 
most important causes has already been noticed, namely, the conges- 
tion of the parts, for several days, at every menstrual period. This, 
amounting as it does almost to inflammation, is often intensified by 
other causes, such as wetting the feet, taking sudden colds, excessive 
fatigue from dancing, and exciting drinks. 



FEMALE DISEASES. 349 



Sexual indulgence often proves a cause of inflammation in these 
bodies. It is particularly apt to have this effect in the newly-married 
female, with whom it is a novel stimulus, and often applied with im- 
moderate excess. In late marriages, when the stimulus to tlie ovaries 
has long been denied, its sudden presentation is liable to make an in- 
flammatory impression. Its entire absence.^ too, in persons of strong 
passions, may result in ovarian disease. 

This inflammation may be produced by the new state of things 
existing at the critical period called the turn of life^ when it reacts on 
the womb, producing the floodings which often bring menstruation 
to a close. The congestion, too, which has been present every month 
for many years, does not immediately cease at this change ; and not 
finding relief by the accustomed flow, the ovarian bodies are exposed 
to inflammation. 

In all large cities, the pest-houses of civilization, where the women 
are more numerous than the men, there are many females whose vir- 
ginity is a burden, and numerous others who give themselves up to 
sexual excesses ; — to both these classes, the turn of life is very liable 
to promote these ovarian disorders. 

There is another class of causes, which, though not so easily re- 
cognized, are equally cogent in exciting this form of disease. I mean 
all those excitements which arise from unbridled thoughts, from books 
of questionable character, from music, social intercourse, and stimu- 
lating food and drinks, — all which promote and intensify burning 
desires, which, though natural and proper in themselves, cannot law- 
fully be gratified in a community where the female sex greatly pre- 
ponderates, numerically, over the male. When we consider how 
powerful within a woman's breast the conflict often is between the 
impulse of passion and the dictates of duty, and how strongly this 
conflict must react upon the sexual organs, and especially upon the 
ovaries, the centre of the sexual system, we can easily see in how 
many cases they may become inflamed. 

Another cause of this disease is suppression of the menses. The 
engorged and crowded state of the vessels of the womb, of the ute- 
rine neck, and of the ovaries, not finding vent in the accustomed flow, 
inflammation in any one of these organs is a very natural result. 

The inflammation of these ovarian bodies is a frequent result, too, 
of a similar condition, previously existing in the neck of the woitib. 
In passing from the uterine neck to the ovarian bodies, the inflamma- 
tory condition often fastens itself upon the broad ligament, the fallo- 
pian tubes, and their fibrinated extremities. (See Plate VIIL, Figs. 
1 and 2.) The whole, it will be seen, presents an amount of disease 
which it is painful to contemplate. 

The womb being turned over, and pressing against one of the 
ovaries, may cause it to inflame by mechanical irritation. Pessaries, 
injudiciously used, may do the same thing. 

Symptoms. — The first and most obvious symptom is a pain a little 
to the right or left of the womb. This pain is almost always increased 
by walking, riding, or by external pressure. It is especially augmented 



350 FEMALE DISEASES. 



by straightening the thigh, by which the parts over the inflamma- 
tion are put upon the stretch. When standing up, ladies suffering 
from this disease, are generally compelled to rest the foot on a stool, 
so as to bend the thigh, and relax the muscles. The pains radiate 
from the ovaries, and go down to the loins and thighs, and sometimes 
to the fundament. They are of a dull, dragging, heavy nature. 

Sometimes the ovarian bodies become vere much enlarged, and 
dropping down, somewhat, press upon the lower bowel, causing con- 
stipation, or upon the neck of the bladder, creating a frequent desire 
to urinate, and an inability to pass the water freely. 

Treatment. — As inflammation of the ovaries is always increased 
during the menstrual flow, it is not proper to meddle with it at these 
monthly periods, lest the trouble be aggravated. Immediately after 
one of the turns has passed, from six to eight leeches should be ap- 
plied over the diseased ovary. When the bites are healed, a blister 
may be used in the same place. The scarf-skin should not be re- 
moved, and the irritated surface must be healed as soon as possible. 
The blister should be camphorated to prevent strangulation. The 
part should next be rubbed for a few minutes, night and morning, 
with an alterative and anodyne ointment (169). 

After the next menstruation, the same things should be repeated, 
and again after the next, and so on, for five or six months, or even 
longer, if need be. The already bloodless condition of the patient 
may require, however, that the leeches should not be applied more 
than once, or, at most, twice. 

The bowels should occasionally be opened by some simple cathartic, 
for the purpose of removing all hard substances which may press 
against and fret the inflamed ovaries. The purgatives employed 
should be of the most cooling kind, such as salts or oil ; while aloes, 
and all harsh cathartics must be avoided. 

Injections of tincture of belladonna and hyoscyamus are useful for 
quieting neighboring parts, and warding off external disturbances. 
They act like soft substances thrown upon the pavement in front of a 
sick man's house. 

The patient should be kept, as much as possible, in the recumbent 
position, lying upon the bed or the lounge, and should only be per- 
mitted to move about to such extent as will not irritate the infjamed 
parts. 

Case. — Miss R. M. B. suffered a great deal of pain every month 
while menstruating. She had also a great tenderness upon pressure 
just at the left of the upper part of the womb, and at times a severe 
pain in the same region, which often extended down into the groin 
and thigh. 

The left ovarium was so much enlarged that it could be distinctly 
felt through the walls of the bowels. 

Immediately after the next monthly period, I applied six leeches 
over the inflamed ovarium, and when the bites were healed, put a 
blister over the same region. After this healed, the same space was 
rubbed^ twice a day, with an ointment (169). Immediately after the 



FEMALE DISEASES. 351 



courses, the same thing was repeated for four months, — the patient, 
each time, being kept quiet for a few days, and then permitted to take 
gentle exercise out of doors. The diet was generally nourishing. 

The patient was well at the end of four months, and has had no 
return of the inflammation. 

This was a simple case, requiring only the most simple course of 
treatment ; but it furnishes the general outline to be pursued in all 
cases of inflamed ovaries. 

Whites. — Leucorrhoea, — Fluor Alhus, 

Leucorrhcea is from two Greek words, Xeu^o? and peco^ and fluor 
albus from two Latin words, albus and fluo, having precisely the 
same meaning as the Greek, namely, a white discharge. Hence, in 
popular language, the disease is called the ^^ whites ;^^ it is also called 
^female weakness.''^ 

These terms are well enough, perhaps, if we have in mind that 
they convey to us only the idea of a symptom of disease. They all 
mean, with the exception of the last, a white discharge from the 
female genital organs. They are slightly inaccurate, as the discharge 
is sometimes yellow, or green, or otherwise variant from white. Any 
discharge from the female genital organs which is not bloody^ comes 
under the term " whites." 

A Sjinptom Only. — As the name of a disease, the term whites has 
no specific meaning. It does not designate any particular complaint. 
It is a symptom, just as the matter expectorated and raised in lung 
diseases is a symptom ; and as such only should it be regarded. 
When persons cough and raise a great deal, they do not, on consult- 
ing a physician, say they have got the expectoration ; but they say 
they fear they have some disease of the lungs, because they expecto- 
rate. They look upon the expectoration as the sign or symptom of 
disease. 

So females, and physicians too, must learn to look upon the whites^ 
not as a disease, but as the sign or symptom of disease, which sign 
they should become skilled in interpreting. 

There is no reason why the discharge from the genital organs 
should not be as well interpreted as the expectoration or discharge 
from the throat. The parts from which it comes, may be about as 
easily and as well inspected. 

IVo Female Ailments so Common, — There are no femaje troubles to 
which the attention of the physician is so often called as these annoy- 
ing and debilitating symptoms called whites ; and there is no depart- 
ment of medical practice, in which the really able, as well as conscien- 
tious and painstaking physician, is so well tested. If, regarding these 
discharges as they are, simply as signs^ he searches faithfully for their 
cause, he will be led to a treatment which in a great majority of 
cases will be successful. And surely no success in life can be more 
prized by a right-minded physician. It procures health, the highest 



352 FEMALE DISEASES. 



earthly boon, for suffering woman, and gratitude, the most prized of 
all rewards, for himself. 

There are Four Kinds of Discharges from the female genital or- 
gans, — mucus, pus, mucus and pus combined, and the watery. The 
first, mucus, does not, in itself, imply disease ; but when pus is dis- 
charged, we know that inflammation exists, because such a cause 
alone 'can produce it. 

Seat of the Disease. — The cause which produces the whites may 
have its seat either in the vagina, or in the neck of the womb ; and 
in practice, it is of course quite important to know where its location 
is. The character of the discharge generally settles this point. If it 
be thin and watery, or thick and cream-like, it is from the vagina or 
passage which leads to the womb ; if ropy, gluey or albuminous, like 
white of eggj it is from the cavity of the uterine neck. 

Treatment, — Some physicians always prescribe the same remedy 
for the whites. They might as well have but one prescription for 
expectoration. The remedy must have reference to the cause of the 
discharge ; until the cause be searched out, every prescription is a 
mere trial at guessing, — a sort of practice well enough adapted to 
quacks, but not becoming scientific men. 

When a case of whites is brought before a physician who under- 
stands his business, he makes no prescription until he has discovered 
what the disease is. Having determined this point, his remedies have 
an intelligent bearing upon the case. This being so, I have no reme- 
dies to set down for. whites, simply as such. I shall proceed, there- 
fore, to speak of several other complaints which bear more or less 
upon this. 

Absence of the Menses. — Amenorrhoea. 

The absence of the menses is divided into two kinds, — retention 
and suppression. It is retention when the monthly flow has never 
appeared, — suppression, when, having been established, it is, by one 
cause or another, stopped. 

Retention Explained. — The ovaries, as we have before said, are 
the centre of the female sexual system. It is the swelling or ripening 
of an ovum or egg, every four weeks, which causes the large flow of 
blood to the parts, and the consequent menstrual discharge. 

But it sometimes happens that the ovaries are not developed at the 
usual time of life. The monthly evacuation does not then appear. 
There is retention. There may be retention, too, from other causes, 
after the ovaries are matured. Costiveness may sometimes occasion 
it, — so may a degenerated and low state of the blood. 

There may be mechanical causes of retention. The mouth of the 
womb may be entirely closed, or the neck may be so constricted as 
to close the passage through it, leaving no outlet for the monthly accu- 
mulation. The hymen, also, may have no opening through it. When 



FE.AL\XE DISEASES. 353 



these mechanical obstructions exist, there are sometimes large collec- 
tions of fluid in the womb, which cause enlargement of the body, and 
in some instances, painful suspicions that the sufferer has committed 
imprudences, and is in the family way. Physicians should be on their 
guard against falling into such errors, and lending the sanction of their 



name to these blasting: mistakes, 



& 



Suppression Explained, — Suppression, — a stoppage after flow has 
been once established, — may be caused by inflammation of the ova- 
ries, — the blood, in this diseased condition, being drawn so entirely 
to these swelling and germinating bodies, that the accustomed flow 
from the w^omb does not take place. 

Inflammation in the neck of the womb may also cause a stoppage. 
So may a fright, as from a fire occurring in the neighborhood, or a 
cold taken by being caught in a shower. Girls sometimes, in their 
utter thoughtlessness or ignorance, dip their feet in cold water, when 
their courses are upon them, and bring on a suppression of a most 
dangerous character. The most lovely and innocent girls have done 
this for the purpose of attending a party; and, in some instances, the 
stoppage induced has ended in death within a few hours. The pro- 
found ignorance of their own mechanism, and of the laws w^hich gov- 
ern it, in w^hich girls are kept who are just budding into life, is a seri- 
ous reproach both to parents and physicians. 

Suppression may be induced by whatever reduces the quantity or 
quality of the blood, as consumption, or by great depression of spirits. 
With some rare exceptions, women have not their turns while in the 
family way. 

Treatment. — Before anything can be done in the way of treatment, 
the case must be thoroughly investigated, and the specific cause of 
the disease searched out. 

If it prove to be retention, and arises from a bloodless condition, 
and an undeveloped state of the ovaries, iron is the proper remedy 
(61) (73) (74) (75), with a generous diet and exercise out of doors. 
If caused by an inflammatory state of the uterine neck or ovaries, 
the proper treatment has been already indicated. If from costiveness, 
relief may generally be found from prescriptions (5) (9). The me- 
chanical causes alluded to above, when found to exist, must be removed 
by gently dilating the mouth of the womb or the uterine neck, with 
bougies, beginning With the smallest, and increasing the size, or by 
puncturing the hymen, as the case may require. 

In Tr^atin^ Suppression, it should be borne in mind that at a cer- 
tain time each month, nature makes an attempt to restore the lost 
function. Even when she is not successful, probably an ovum is ma- 
tured and in some way disposed of. The intelligent physician will of 
course avail himself of this favorable moment to try his skill in bring- 
ing about the desired regularity. When this time arrives, he should 
order three or four leeches applied to each groin at night. The next 
night, he should direct the use of a pungent foot bath (242) ; also (16) 
as a cathartic. 

45 



354 FEIVLA-LE DISEASES. 



When suppression exists, it is not always proper to try in this 
direct way to bring on the turns. There may be no blood to spare ; 
and this may be the sole reason why the courses do not appear. 
When this is the case, nothing is to be done but to build up the 
health as rapidly as possible, and when this is sufficiently established, 
the courses will be all right. 

Profuse Menstruation. — Menorrhagia. 

Menstruation may continue too long; or occur too often, or be too 
p^'ofuse while it lasts; or all these irregularities may be experienced by 
the same person. Any one of them will prove a serious irritation, 
and a drain upon the constitution ; the whole together, if not arrested, 
will undermine and destroy it. 

The Cause of this, like the sourse of all other female diseases, is, 
in a great majority ^f cases, overlooked. 

It is not to be attributed, as so many suppose, to a congested state 
of the womb ; but is rather the result, in a great many instances, of 
the inflammatory or ulcerated condition of the uterine neck. 

In still another large number of cases, it arises from a succession 
of ovarian abortions. When the blood has run low, and nutrition is 
defective, as in the consumptive habit, the ovarian vesicles fail to 
reach maturity. Like other products of the economy, they become 
blighted, and abort. And as these blights occur often, nature is busy 
every two or three weeks in casting them off. Hence, the menses 
appear often. They come and go without order, because they spring 
from a process which is a contraversion of nature's laws. 

Explanation. — It is not easy to explain how inflammation and 
ulceration of the uterine neck should in one case produce suppression, 
and in another profuse menstruation. Yet it is a settled truth, that 
such opposite results do come from one and the same apparent cause. 
Probably the explanation is to be found in the different degrees of 
inflammatory action, in the varieties of constitution, and in the vari- 
ant degrees of tenacity with which the vessels hold the blood. 

Bleeding from the female genital organs may be produced by a 
variety of causes which have nothing to rio.ise. 

do with menstruation. Such bleedings 
are properly uterine or vaginal hemor- 
rhages, and not profuse menstruation. 
They are the result of inflammations, 
or tumors within the uterine neck (Fig. 
136), or weakness. The womb may 
bleed for days, or even for months, from 
pure debility. 

Treatment, — As profuse menstruation 
and uterine hemorrhage spring from a 
variety of causes, so the remedies are various. Here again we are 
confronted with the same absolute necessity to investigate accurately 




FEMALE DISEASES. 355 



the true nature of the complaint, before we venture a single prescrip- 
tion. All the cases present one general feature. There is too great 
a loss of blood ; and the first thought is that astringent medicines are 
necessary to arrest it. But if the bleeding be occasioned by a poly- 
pus, or by inflammatory ulceration, astringents would not arrest it, 
and might do great mischief. 

When the immoderate flowing is caused by a general breakdown 
of the nutritive powers, and by ovarian abortions, the great aim must 
be to rally the vital powers by iron, quinine, porter, wine, a generous 
diet, exercise on horseback and on foot, and warm and cold bathing. 
^\'hen produced by local diseases of the ovaries and neck of the 
womb, the treatment is to be local, — such as has been described. If 
a polypus, or other tumor, be the cause, the remedy must be sought 
for under the appropriate head. If the womb has become relaxed, 
and bleeds from pure debility, — as it may, — something must be 
found, if possible, which will condense its substance, — making it 
harder, smaller, and more solid. For this purpose, cold bathing, a.s- 
tringent injections into the front passage, and acid drinks, are useful. 
But one of the best remedies is the wine of spurred rye (267). One 
teaspoonful should be taken three times a day. This article, by caus- 
ing the womb to contract, solidifies and condenses it, — thus arresting 
the blood which oozes from its relaxed tissues. 

Case. — Miss S. F. was treated, in 1855, for great loss of blood by 
too frequent and too profuse menstruation. She had suffered for a 
number of years, — her courses coming on every three weeks, some- 
times every two weeks, and lasting from a week to ten days. She 
had become very pale, and much debilitated ; and, as she had a slight 
cough, her friends feared that, if not relieved, she would soon sink in 
consumption. 

Having made an examination, and learned that there was no or- 
ganic disease, but that the exhaustive bleeding was caused entirely 
by debility, I prescribed sulphuric acid (60) three times a day, with 
half a pint of cold water injected into the bowel once a day, and qui- 
nine (67) three times a day. 

The patient was required to take a very generous diet of juicy 
meats, broths, etc., and to be in the open air to a reasonable extent. 

The case began immediately to improve, and in a few weeks the 
courses were restored to a healthy state. No other treatment was 
used, except to drop the sulphuric acid in two instances, for a few 
days, using in place of it, tannin in one case, and alum in the other. 

Painful Menstruation. — Bysmenorrhoea. 

Dysmenorrhctja is from three Greek words Su?, ^r)Vy and peo), which 
mean, literally, a difficult monthly flow. These words do not precisely 
describe the complaint ; for it consists not so much in a difficulty as in 
a painful flow. 

Symptoms, — This affection is always marked by more or less pain 



356 FEMALE DISEASES. 



while the courses are on, — especially during the first day or two. 
The pain sometimes begins two or three days in advance of the evac- 
uation. It extends over the whole lower part of the belly, — running 
down, at times, to the thighs, and causing great distress in the back. 
It is frequently so violent as to resemble the pains of labor, compell- 
ing the sufferer to take the bed, and drawing from her tears and 
groans, and occasionally throwing her into spasms most painful to 
witness. So terrible are the monthly sufferings which some women 
experience from this cause, that the anticipation of it destroys much 
of their peace, even during the intervals of respite. 

The Causes of this complaint are very numerous. There is, doubt- 
less, such a thing as pain in the womb from rheumatism, and espec- 
ially from neuralgia, though these are much rarer forms of the com- 
plaint than many suppose. 

Pains at the monthly periods are often induced by a displacement 
of the womb. If the organ fall over backward or forward, its nerves 
are pressed upon in an unnatural way, and when the parts are 
crowded with blood, it is very natural for painful sensations to be 
excited. In these cases, the neck of the organ is bent at right angles, 
and the canal which passes through it is of course strictured^ so that 
the evacuations are necessarily made with difficulty. 

And this leads me to remark, that the passage through the uterine 
neck, becomes, occasionally, from inflammation or other cause, almost 
closed. The result is, much difficulty and great pain in passing the 
monthly secretion. 

There are no causes which excite painful menstruation more often 
than inflammation in the uterine neck and the ovaries. An increased 
flow of blood to an inflamed part always causes pain. An inflamed 
foot or leg has to be laid up in a chair, because it aches when put 
down. The reason is, that when hanging down, it is more full of 
blood, and the sensitive nerves are painfully compressed. When the 
finger is hot with inflammation, we assuage the pain hy holding it up 
for the blood to run down. For the same reason, the inflamed ovaries 
and uterine neck ache when the blood flows to them, in large quan- 
tities, at the menstrual period. 

Congestion of the lining membrane of the womb itself is a frequent 
cause of painful menses. It is a condition of the membrane of the 
womb, similar to that of the larynx in membranous croup. There is the 
same pouring out of what physicians call coagulable lymph, which 
forms itself into a membrane. This membrane the womb strives by 
strenuous contractions to throw off, and finally succeeds in expelling 
it, not whole and entire, but in shreds and patches. These shreds, 
which women sometimes call skinny substances, are characteristic of 
the disease. The efforts to expel them cause pains very much like 
those of natural labor, and sometimes almost as severe. 

Treatment. — Painful menstruation, excited by the falling over of 
the womb, backward or forward, is cured, of course, by putting the 
organ back into its proper position. 

Pains caused by stricture of the canal through the uterine neck, are 



FEMALE DISEASES. 3o7 



cured only by enlarging the passage. This is effected by introducing 
at first a very small bongie, and then a larger and a larger, until the 
passage is of the usual size. It is a delicate operation, quite success- 
ful in careful and skilful hands, but liable to produce mischief when 
improperly conducted. 

In all the forms of this disease, the treatment should aim, not 
merely at palliation, but at a cure. And generally, 1 am happy 1o 
say, a cure is attainable. Yet how many women suffer for years, 
until health has fled, and life has become a burden, — receiving from 
their medical attendant the assurance that palliation only is pos- 
sible ! 

It is necessary at each monthly turn, to do something, in these 
cases, to quiet the pain. For this purpose, twenty drops of lauda- 
num, in a wine glass of tepid water, thrown into the bowel, will be 
highly serviceable. For a like purpose, one pill (116) may be taken 
twice a day, beginning one day before the menstrual flow. A bella- 
donna ointrnent (170) may be rubbed upon the neck of the womb 
with great advantage. 

In the congestive form of this disease, — that in which the membrane 
is formed on the internal surface of the womb, and thrown off infrag-- 
vients, — the liquid acetate of ammonia, or spirits of Mindererus, is a 
very valuable remedy taken in two teaspoonful doses, in a table- 
spoonful of cold w^ater, three or four times a day, while the pain lasts. 



Case I. — Miss E. S. of B., aged twenty-two years, applied, in 
1856, for relief from great suffering at her monthly periods. Her 
menses had been disturbed some time before by taking cold, since 
which time, her mother stated, her pains, for a short time before the 
flow began, and during the first day, had been terrible, not much less 
severe, indeed, than those of natural labor, or child-bearing. The 
pains, at these times, had been of a terribly bearing-down kind ; had 
frequently. been preceded and accompanied by sickness, vomiting, and 
fever ; and finally, what came from her at first was not so much 
blood, as a kind of skinny substance, in shreds and patches. 

It was immediately evident that this was a case of painful men- 
struation (dysmenorrhoea) of the congestive kind. The womb was 
every month too full of blood, — its internal surface, in fact, if not its 
whole substance, inflamed. Hence, a false membrane like that of 
croup, was formed, which the womb contracted and struggled hard to 
throw off, and finally tore to pieces, and expelled in shreds. 

Of course this local inflammation was to be reduced, which was 
done by first giving a brisk purge (31), which was followed by apply- 
ing half a dozen leeches directly over the womb. On the following 
day, a blister was raised in the same place. In two weeks, three 
leeches were applied, and again followed by a blister. These appli- 
cations were repeated every fortnight, for three months, being careful 
not to use them within three days of the monthly turns, either before 
or after. 

The pain, at each turn, was assuaged, by injecting into the bowel 
twenty drops of laudanum in a gill of tepid water, by rubbing upon 



358 FEMALE DISEASES. 



the mouth of the womb some of the ointment (170), and by giving 
two teaspoonful doses, in a little cold water, of the liquor of acetate 
of ammonia, three times a day. 

The patient was cured in three months, and has since had easy and 
natural menstruation. 

Case II. — Mrs. L. C. was treated for a case of painful menstrua- 
tion, in 1857. 

The lady also had terrible pains, attended by forcing down as if 
her bowels were all coming out of her. Yet she had but a very 
scanty discharge. Every month she was made literally sick, and 
was obliged to take to her bed. 

On examination, it was found that the great difficulty in passing 
the menstrual fluid, as well as the scantiness of the quantity, was 
owing to the smallness of the passage through the neck of the womb ; 
this passage was nearly closed up ; it was strictured. 

There could be no doubt as to the treatment required. Medicines 
could do no good. This passage must be gradually opened. To do 
this, I introduced a small metallic male catheter into the strictured 
passage, and, gently turning it once or twice round, withdrew it. 
This was done once in three days, for three months, — using each 
time a slightly larger instrument. Thenceforward, her menstruation 
was natural and easy. She was well. 

Chlorosis. — Green Sickness. 

Before the age of puberty, the girl is only a child. She has within 
her only the elements of a woman. The change to which she is des- 
tined, brings with it a wonderful development both of body and 
mind. 

To effect this development, and bring out the new being in the 
perfection designed by the Creator, a large amount of hidden nerve 
power is required. She requires to have been born with a well-vital- 
ized constitution, and to have been physically trained in a way to 
harden and energize it. Without these antecedents, her develop- 
ments at puberty will be feebly and imperfectly made. Her devel- 
opment and evolution of germs will be so defective as to cause her 
menstruation to be only partially established, or to fail altogether. 

Symptoms. — Where the inherent powers of the system are just 
sufficient to bring about a first menstruation, it often happens that 
they seem to be spent by the effort, and that the evacuation fails to 
appear again for several months. Indeed, the whole organization may 
break down at this point, and become blasted, as it were, like a blade 
of wheat which has grown well for a time» but which fails to develop 
the kernel. 

The blood at this period, may become impoverished, and fail to 
distribute adequate nourishment and development to the various tis- 
sues. When this occurs, it loses a part of its red globules, and in- 
creases its watery portion. As a result, the skin becomes pale, and 



FEMALE DISEASES. 3-39 



sometimes of a yellowish hue; the bowels become torpid and con- 
fined ; the nervous system sensitive and weak ; the digestion is im- 
paired ; the appetite is either lost, or perverted, — longing for unnatu- 
ral food ; the tongue is white ; the heart palpitates ; the spirits are 
depressed ; the temples and ears throb ; the head occasionally aches 
and whirls with dizziness ; the sleep is disturbed and abbreviated ; 
and hysterics are now and then superadded to close the catalogue 
of ills. 

This is Chlorosis, briefly depicted in its origin and its symptoms. 
The word is from the Greek 'xXcopo^;, which means green and pale. 
By nurses it is called the " green sickness." 

Its Causes are quite numerous, among which may be reckoned im- 
poverished diet, damp atmosphere, sedentary habits, long confine- 
ment indoors, overworking the mind in childhood, constipation of the 
bowels, and an inherited feeble constitution. 

Treatment. — Chlorosis, as a general thing, is connected either with 
retention or suppression of the menses ; and in treating it, physicians 
are too much in the habit of resorting indiscriminately to forcing 
medicines, called emmenagogues. From such practice, great injury 
often results. 

It is not always sufficiently considered that a woman fails to men- 
struate, or ceases to do so, because she is sick ; and if we would cause 
her courses to return, ive must restore her health. To do this should 
generally be the great object of treatment. Let the health be restored, 
and the menses will come back. The only philosophical treatment is 
that which will invigorate the system. 

In chlorosis, the vital powers are in a state of dilapidation. How 
can they be roused ? By exercise on horseback and on foot ; by wear- 
ing clothing enough to keep warm ; by a tepid bath two or three times 
a week, and brisk rubbing with a coarse towel ; and by a generous 
diet, composed of tender meats, animal broths, etc. 

This treatment, however, should be preceded by unloading the 
Dowels with prescription (35) or (40), according to choice. One pill 
should be taken at night. When the liver is considerably deranged, 
prescription (40) will be particularly serviceable. Half a pint of 
tepid water thrown into the bowel, night and morning, will help 
relieve costiveness. 

The bowels having been well opened, give a tablespoonful of pre- 
scription (59), two or three times a day; or, of prescription (60), a 
teaspoonful, the same number of times, each day. 

In the treatment of this disease, iron, in some form, is almost al- 
ways needed. Prescriptions (61) (71) (73) (74) (75) (80) and (316) 
are suitable preparations. 

A girl suffering from this disease should always be taken out of 
school. The mind should be divided between rest and recreation. 

Case. — Miss J. T., aged nineteen, was treated by me for this com- 
plaint in 1858. 

She had always been delicate. Her first menstruation was at the 



360 FEMALE DISEASES. 



age of fourteen ; but it was quite defective in quantity, and was 
imperfectly repeated two or three times, at irregular periods, when it 
stopped altogether, and had not again appeared up to the time of her 
being brought to me. 

She was very pale, and a little yellowish, — her lips being nearly 
white. She was very costive, — habitually so, — was without appe- 
tite, and her tongue was coated white. She had dizziness, palpita- 
tion of the heart, neuralgic pains in various parts, and was extremely 
nervous and irritable. Having, in addition to the above symptoms, a 
pretty constant cough, her friends feared consumption, and brought 
her to me from some distance for that reason. 

I found no physical signs of lung disease, and had no difficulty, 
therefore, in making it out to be a case of chlorosis^ — particularly as 
there was no expectoration attending the cough. 

The parents were chiefly anxious to have the menses brought on. 
With me, this was of minor consequence ; the main thing was to rally 
the prostrate powers of life, and restore the blood to health. 

To do this, it was necessary to rouse the liver, for which I gave 
leptandrin, etc. (34), which I ordered to be taken once a day, namely, 
at bed-time. This not only caused a flow of bile, but the scutelarine 
calmed and strengthened the nervous system. 

It was necessary, too, to correct the habit of costiveness. To 
effect this, she was ordered to take two teaspoonfuls of Mettauer's 
aperient, after breakfast and dinner. 

To restore the blood, iron was ordered, particularly the citrate of 
iron and strychnine (316). This had a fine effect to raise the blood 
and support the nervous system. 

She was ordered a generous diet of tender meats, broths, etc., and 
to take unrestrained and free exercise out of doors. 

Her improvement was immediate and visible, and was not inter- 
rupted during the three months of her stay in Boston. Soon after 
her return home, her menses appeared, and she has since enjoyed 
pretty good health. 

Cessation of the Menses.— Turn of Life. 

There is probably no period in woman's earthly existence which 
she approaches with so much anxiety as that which she is in the 
habit of calling " the turn of life." The anxiety is not without some 
reasonable ground for its existence. She has been accustomed, for 
thirty years or more, to lose, every four weeks, a certain amount of 
blood. When this evacuation stops, disturbances of the system may 
well be expected. So well is this understood, that this climacteric 
has come, by general consent, to be called the " critical period " in 
female life. 

If it be well and safely passed, the health is generally better than 
before, and a " green old age " is likely to follow. But if the seeds 
of disease are in the system, — if there be a tendency to cancer or 
other malignant disease, which has been held in check by the monthly 
flow, it now takes up its destructive work, and shows itself; or, if 



FEMALE DISEASES. 361 



there be a predisposition to apoplexy or congestion of any organ, it 
is more likely to become active, now that the accustomed waste-gate 
is closed. A distinguished writer has said that about half the deaths 
among women, about the age of forty-four, are from cancer. 

Nenous Complicatioiis. — It is the duty of the physician to look 
carefully after those females who come under his care at this critical 
time. For, in addition to the organic and malignant diseases which 
attack her at this time, she is exposed to a host of nervous irritations, 
which, if neglected or badly managed, make her life a cross and a 
burden. The symptoms of these irritations are in number, legion. 

Ag:e at which the turn of life comes. — As a general rule, the turn 
of life comes bet\veen the ages of forty and fifty ; but occasionally 
occurs at other periods, varying from thirty to seventy. If the menses 
appear early in life, they terminate early. 

Sjiiiptonis. — When there is a tendency to corpulency at this period, 
the symptoms are headache, dizziness, and a sense of suffocation. It 
is common, when the period of cessation approaches, for deviations 
from regularity to occur. At one time the menstrual discharge will 
be profuse ; at another, scanty. It will now disappear for a time, 
and be replaced by the whites. Then it will appear for a few times 
with considerable regularity. Next will come a suspension for sev- 
eral months, to be followed by a flow of such profusion as to amount 
almost to flooding. 

Mixed up with these irregularities, will be palpitations of the 
heart, constipation of the bowels, a variable appetite, and broken 
sleep, weakness and inquietude, timidity, a dread of impending evil, 
irritability of temper, hysterical attacks, bad feelings in the head, with 
sounds in the ears, as of the rolling of carriages, sparks before the 
eyes, and an unsteady gait. 

Treatment. — K there be at this period, fulness of habit, with diz- 
ziness, headache, sparks before the eyes, a sense of suffocation, etc., 
there is a plain indication that the brain is oppressed with too much 
blood. I am not much in favor of bleeding, but this is a case in 
which from a gill to a half pint of blood may, if ever, be drawn from 
the arm with positive advantage. Cups applied to the back of the 
neck will also be useful. Give at night, also, three of the compound 
cathartic pills, and then keep the bowels regular with prescription 
(18), — a wine-glassful to be taken occasionally. The diet should be 
spare, and strictly vegetable : — to which should be added much daily 
exercise. 

Purging should not, in any case, be carried too far. If nervous 
affections show themselves, with disturbance of the digestion, and 
general debility, even leeches would be improper, and physic should 
be swallowed very sparingly. 

When serious organic disease is suspected, — as cancer, — it is the 
duty of the physician to investigate the case very thoroughly, and to 
give the patient the advantage of the most prompt and decided 
treatment. That treatment is spoken of in the proper place. 

46 



362 FEMALE DISEASES. 



Hysterics. — Hysteria, 

The name of this complaint is from a Greek word, signifying the 
womb. It took this name from the belief that this organ is the seat 
of the irritation which produces the hysteric disturbance. 

This belief is correct, if we include with the womb, the ovaries, 
and the other sexual organs. The sexual system is doubtless the 
centre of the reflex nervous derangement, called hysteria. 

It has been sufficiently demonstrated that hysterics are dependent 
for their existence either upon organic disease, or upon simple irrita- 
tion of the sexual organs. Sir Benjamin Brodie mentions cases of 
the hysteric paroxysm, produced by pressing upon an inflamed and 
tender ovary. 

Symptoms. — An attack of hysterics is generally preceded by de- 
pression of spirits, restlessness, and a frequent desire to pass water. 
It is sometimes marked by convulsions, or fits ; at other times, it is 
not. At times, the attacks are local, and are manifested by spasms 
of the throat at the top of the windpipe, or in the bronchial tubes ; 
the patient feels a ball rise up in her throat (globus hystericus), her 
heart beats violently, and she laughs and cries by turns. 

When the disease is more general, the muscles of the limbs are 
thrown into spasms; the patient struggles violently; rising up in a 
sitting posture, and then throwing herself back; twisting the body 
from side to side, clenching the hands, and throwing the arms about, 
so that she is with difficulty held by persons much stronger than her- 
self. Soon after these paroxysms, the patient generally passes a large 
quantity of very pale urine. 

The Causes of this complaint are as numerous as the causes of 
'female diseases, for in truth there is no female complaint wiiich may 
not produce it. Whatever develops and excites the sexual system, 
and at the same time weakens the constitution, lays the foundation 
of this malady. Nervous women are much inclined to it. In large 
cities there is more of it than in the country, because there is more 
excitement and luxury, and more of their consequences, — nervous 
and female diseases. 

Treatment. — To treat this complaint successfully, it is necessary to 
search out its cause, and remove that. Like the whites, it is not so 
much a disease in itself, as a symptom. 

The first inquiry to be made should have reference to the real 
origin of the complaint. Is it dependent upon inflammation of the 
ovaries or the womb, or to displacement of this latter organ ; or does 
it arise from the low state of the blood, and the weakened condition 
of the nerves, acted upon by some irritation or heightened sensibility 
of the sexual organs. 

If dejicndent upon inflammatory disease, that is to be treated ac- 
cording to directions elsewhere ; if upon falling of the womb, no 
remedies will avail, until that is put in its proper place. If diluted 



FEMALE DISEASES. 363 



blood and weakened nerves be the cause, iron and quinine are the 
remedies. When the complaint arises from deficient menstruation, 
iron and aloes (47) will be serviceable. The nervous spasm can 
sometimes be broken up by pouring cold water upon the head, or 
face, or limbs of the patient. 

Tlie Hygienic and Moral Treatment are of great consequence. The 
complaint is very much under the control of the will. Whatever 
tones the moral nature, and strengthens the will, tends to subject this 
disorder to the control of the patient. Plain wholesome diet, exercise, 
bathing, and the enforcing, as far as possible, of a rugged, self-reliant 
habit, generally go far towards breaking its force. 

Polypus of the Womb. 

This is simply a foreign body, or tumor, growing either within the 
womb, or -in the vagina, and attached to the uterine neck. It is rather 
a serious affection. 

These tumors vary in weight from half an ounce and less, to many 
pounds. They are, in color, whitish, red, brown, and even black. 
They have almost every consistence, — being soft, spongy, gristly, 
and hard. 

The Symptoms of polypus are various, resembling those of almost 
every other womb complaint. It is often mistaken for displacement 
of the womb, for dropsy of this organ, and for pregnancy. 

These tumors are apt to give rise to dangerous bleeding from the 
womb, and other discharges which greatly weaken and derange the 
system. They are liable to terminate in cancer. In pregnancy, they 
may produce miscarriage. When they are suspected, therefore, the 
utmost scrutiny should be employed to search them out. This is 
especially desirable, since the fallen or inverted womb may carelessly 
be taken for a polypus, and be operated on as such. 

Treatment. — This is of two kinds, medical and surgical. The 
first consists in means of supporting the strength of the patient, and 
checking the discharges by means of injections, rest, etc., and in en- 
deavoring to cause the removal of the tumor by absorption. 

This last object is sometime effected by an unstimulating diet ; 
and by the use of iodine (101) for some time. This treatment does 
not often succeed, however, and cannot be relied upon. 

If the polypus be within the womb, of course it cannot be reached. 
The only thing to be done, in such case, is to cause its expulsion. 
This is sometimes effected by causing the womb to contract by the 
use of spurred rye (267), or by the use of the electro-magnetic 
machine. This latter remedy can do no harm, and had better be 
tried first. 

When the polypus is outside the womb, the methods of removing 
it are various. It is sometimes done by cauterization, or burning it 
off by hot iron or caustic. This is a harsh method, and not resorted 
to by skilful surgeons. Another method is that of crushing the tumor 



864 EEMALE DISEASES. 



with an instrument. Another still is that of torsion, or twisting it 
off. And still another, that of applying a ligature, or tying a string 
around the neck of the tumor, and strangling it by preventing the 
blood from going to it. By this means it falls oft' in a few days. 
There is one other method, that of cutting the tumor away with a 
knife, or with a pair of curved scissors. These three last methods 
are the chief ones now used by skilful surgeons. 

Case I. — Mrs. J. W. H., from one of the cities in New England, 
applied for treatment for an affection of the lungs, from which she 
had suffered for several months. She was thin in flesh, feeble, and 
pale from loss of blood; for she informed me that her courses had 
been upon her a large part of the time for several months. I tried 
the usual remedies for profuse menstruation (for she at first declined 
an examination), but without effect. The hemorrhage was unabated, 
and she rather lost ground. I again proposed an examination, and 
apprized her that upon it hung the only hope of my being able to do 
anything for her. She assented without further hesitation. 

Upon introducing the speculum, a pendulous tumor, hanging from 
the mouth of the womb, immediately dropped into it, precisely like 
that in Plate VIIL, Fig. 3. I immediately put a ligature around its 
neck, and in a few days it came away. Upon being apprized of this, 
I applied to the root a small amount of acid nitrate of mercury, with 
a camel's hair pencil, and immediately after pressed upon the cauter- 
ized surface a small velvet sponge, thoroughly wet with soap suds. 
By this last application, the acid was decomposed, and prevented 
from spreading. The bleeding stopped at once. Under the use of 
iron, and a thoroughly rallying treatment, the lady began to come up. 
The affection of the lungs, no longer encouraged by the drain upon 
the system, gradually yielded, and she recovered. 

Case II. — An unmarried lady, from an interior town in another 
state, sought relief for a throat disease, complicated with a slight 
affection of the lungs. As my custom is, I inquired respecting her 
menses, and learned that her " turns," as she said, came upon her 
every two weeks, or oftener, — indeed, that she was seldom entirely 
free from some flow. U*|)on making an examination, — to which, 
like a sensible woman, she assented without hesitation, — I found 
about the mouth of the womb, as in Plate VIIL, Fig. 2, several 
small projecting tumors, looking like ripe, red currants. With the 
forceps, 1 took hold of them, and in a few moments, without pain to 
the patient, I twisted them all off; and then made the same applica- 
tions as in the preceding case. The bleeding was ended at once; and 
the patient got well, not only of the hemorrhage, but of the throat and 
lung complaints. 

Uterine Hydatids. 

This name is given to a bladder-like substance, occasionally found 
growing in the womb. It is filled with a white or yellowish fluid. 



Pl.B 



Pio.i 



^^^^a^^^r 








Fie. 2 




Mg.3 




Fi^ 4 




FEMALE DISEASES. 365 



Sometimes a bundle of them grow together, like a bunch of grapes. 
Some are elongated, like a bean, and have a sort of claw, by which 
they are attached ; others are shaped like an egg. 

Those with a claw are generally supposed to be living beings, like 
worms in the bowels. When expelled from the womb, they move 
about if placed in warm water. 

The Causes which produce these singular growths, are obscure. 
Probably whatever improperly excites or irritates the uterine organs 
may produce these vesicular bodies. 

Tlie Symptoms may be easily mistaken for those either of preg- 
nancy, or of water or inflammation in the womb. 

From the growth of these bodies, the bowels may enlarge, the 
breasts swell, and the menses stop. If to these symptoms be added 
sickness at the stomach, the woman, if married, feels confident she is 
in the family way. There is no certain method of correcting this 
mistake, until the collection of bladder-like bodies is expelled from 
the womb. 

It is rare that these bodies appear in the virgin woman. They are 
supposed to be connected, in some way, with imperfect conception. 

Treatment, — No very exact directions can be given in regard to 
treatment, because we can seldom say absolutely that hydatids exist, 
until we see them expelled. Whatever will produce contractions of 
the womb, will cause their expulsion ; but it will not do to give these 
remedies indiscreetly, lest the cause be one of real pregnancy instead 
of hydatids. 

Inflammation of Womb. — Metritis, 

This disease very often follows delivery, and is connected with 
child-bed. fever. 

Various Causes also produce it in the unimpregnated state. The. 
inflammations of the ovaries, or of the uterine neck, may extend to 
the womb. Falling of the womb may cause it to be irritated by 
being placed in a new position, and thus bring on inflammation. In 
some temperaments, marriage may produce this disease ; in others, 
singleness. It may also be brought on by painful menstruation, by 
forcing medicines, by constipation, by tight corsets, by solitary vices, 
and by excited sexual feelings. 

SjTUptoms, — When the membrane lining the womb is involved in 
the inflammation, the symptoms are dull, constant pain in the region 
of the womb and in the loins. The passage of w^ater or feces causes 
pain. There is a sense of weight which causes the patient to bear 
down and strain, as in labor. The belly swells, and is painful and 
tender, not bearing even the weight of the clothes. There are chills, 
fever, and sometimes even delirium. 

Treatment. — In this, the aim must be to reduce the inflammation. 



366 FEMALE DISEASES. 



The bowels must be opened with some saline medicine (18), perspi- 
ration must be induced, and the hands and feet must be made warm. 
A large meal poultice should be put upon the belly, and leeches or 
cups on the inside of the thighs. The patient should lie upon the 
back with her knees raised so as to keep the clothes from pressing on 
her. If the purgative medicine does not operate, an injection (249) 
should be used. 

The food must be reduced almost to entire abstinence, and no stim- 
ulants whatever should be taken. The room must be well ventilated, 
and kept still. 

Tailing of the Womb. — Prolapsus Uteri, 

The womb is often found out of its natural and proper place. 
There are certain ligaments and muscles intended to act as stays, 
and hold it up in its position. These, from various causes, become 
rlaxed. It then, losing its support, drops down into the vagina, be- 
tween the bladder in front and the large bowel called rectum, behind. 
It is then said to he fallen^ or prolapsed. 

The womb of married women is more apt to become prolapsed 
than that of the unmarried, because it is more liable to have its weight 
increased by congestions. 

The Symptoms are dull pain in the' small of the back, a dragging 
sensation in the groin, and a feeling of fulness around the funda- 
ment. 

Treatment. — The complaint is easily cured if the remedies be 
applied early. If the falling be occasioned by a relaxed and weak^ 
ened condition of the parts, a very effectual relief may sometimes be 
derived from simple injections of cold water into the front passage, 
alternating them sometimes by an infusion of white oak bark, or of 
nut galls, or a solution of tannin. 

If the womb have been long down, these simple remedies will not 
be sufficient to restore it. It is then necessary to put it back in its 
place, and employ some mechanical means to keep it there, until the 
ligaments and muscles recover their strength so far as to hold it. For 
this purpose, passaries, of various styles and materials, are employed. 

Tailing Over of the Womb. 

Anteversion. — The womb sometimes falls over forward upon the 
bladder, towards the pubes. This is called anteversion. The top is 
turned forward to the bladder ; the mouth, back towards the large 
bowel. (Fig. 137, h.) 

Retroversion, — When the womb falls over hackivard^ between the 
rectum and the vagina, it is said to be retroverted^ d. This is just 
the opposite of being anteverted. In this displacement, the mouth is 
turned forward, the top backward. 

This displacement may occur suddenly or gradually. If the former. 



FEMAI.E DISEASES. 



367 



there is generally great distress, and the organ should be immediately 
put back in its place ; if the latter, the pain will be less intense, and 
the replacement must be effected by pessaries, — particularly with the 
ring pessary, made from India rubber. 

Fig. 137. 




Anteflexion and Retroflexion. — When these occur, the womb is 
doubled upon itself^ the mouth of the organ not being tilted up before 
or behind, but retaining its natural position. These flexions are rep- 
resented by a, c, and e. 

Beside these more common displacements of the womb, there are 
several slighter deviations which it is scarcely necessary to describe. 
There is the obliquity of the womb, which is simply a leaning' of the 
organ backward or forward, or to one side. 

There are still other more serious troubles, which are so very rare 
as not to require me to dwell upon them, such as the inversion of 
the womb, or turning it wrong side out, like the finger of a glove ; 
and the hernia of the womb (hysterocele), which is like that of the 
bowel. 

Inflammation of the Vagina. 

This may be produced by many of the same causes which induce 
inflammation of the uterine neck. It may follow tedious child-bear- 
ing, — especially if instruments have been used. Marriage is not 
an infrequent cause of it, — so may a pessary be, if an improper 
one. 

The Symptoms are pain in the groins, a feeling of heat and tight- 
ness in the passage, and a difiiculty in passing water. In a few days 
a discharge, like gum water, begins to flow, which gradually becomes 
thicker, like cream, and is green or yellow. Sometimes the disease 
gets well in a few days;iat other times, it degenerates into the chronic 
forms, and lasts a long time. It should be cured as soon as possible. 



368 



FEMALE DISEASES. 



lest the inflammation cause the walls of the passage to grow together, 
and make a stricture, as in Fig. 138. 

In this Figure, ^, represents the mouth 
of the womb ; a, is the lower entrance to a 



Fig. 13S. 



narrow passage in the vagina, called a 
stricture. It is caused by inflammation, 
which so thickens the walls of the vagina 
as to bring their inner surfaces near to- 
gether. In examining a case of this sort 
a practitioner needs to be on his guard les1 
he mistake the entrance to the stricture, a, 
for the mouth of the womb, 6, — a mistake 
which might lead to evil consequences aL 
well as seriously damage his professional 
character. 

Treatment, — The diet should be light 
and unirritating. The bowels should be 
kept open. A cooling wash (207) (218) 
should be used several times a day, until 
the discharge becomes thick, — then employ 
injections (232) (202) (244) (243) of a more 
astringent nature. Let the marriage bed 
be abandoned till the recovery is complete. 

When the discharge arises from small 
granular elevations upon the inner surface 
of the vagina, the whole diseased surface 
should be painted over with a solution of 
nitrate of silver, twenty grains to the ounce 
of water, ^ — the disease being brought to 
view by the use of a speculum. This may 
be done every other day. 




Itching of the External Parts. — Prurigo of the Vulva, 

This complaint is apt to attack females about the 'cessation of the 
menses, though they are liable to it at other periods. It is a most 
annoying and distressing affection. So terrible and tormenting at 
times, is the itching of the external genitals, that the woman is una- 
ble to avoid rubbing and scratching, and she is occasionally compelled 
to absent herself from all society. She feels, as she says, as though 
she should tear herself to pieces. 

Sometimes this irritation of the sexual organs excites venereal 
thoughts so dominant and controlling as to constitute a real mania, 
called nympho-mania^ from the name of a part involved. 

This complaint generally indicates some disease of the womb, or 
its appendages, or of the bladder. When this is the case, of course 
it cannot be cured without seeking out and removing the disease, of 
which it is a symptom. 



FEMALE DISEASES. 369 



Treatiiieut. — To alleviate the local suffering, the lotion (223), or 
the ointment (171), may be applied to the parts several times a day. 
I prefer the lotion. A weak solution of nitrate of silver (211) will 
sometimes do well. 

When the disease is brought on by masturbation, as it sometimes is, 
this habit must of course be broken off before a cure can be effected. 
In this case, also, cold water must be applied to the parts several 
times a day ; some of the preparations of iron should be taken, and 
some active employment be engaged in, which shall absorb the ener- 
gies of mind and body. 

Sterility or Barrenness. 

It has doubtless occurred to every person who nas thought upon 
the subject, that there must be some special reasons why so many 
women do not and cannot bear children. These reasons I propose 
now to explain as simply and as plainly as the nature of the subject 
admits. To this explanation, I shall add some remarks upon treat- 
ment ; for, in nine cases out of ten, barrenness is completely curable. 

Reproduction. — Throughout nature, life is perpetuated by repro- 
duction. The vegetable and the animal die ; but before death comes, 
they reproduce the germ of a new thing or being, which lives after 
them. The law of reproduction, throughout the realm of nature, is 
one, and but one. All living things have male and female structures. 
Every new being is evolved from an egg^ the product of an antece- 
dent parent. 

Reproduction consists in the growth of an egg or germ in connec- 
tion with some living part, until it is capable of independent exist- 
ence. This germ or egg is the product of the female parent, and will 
abort or perish unless brought in connection with a fructifying fluid 
from the male. Thus, two palm trees, growing about forty miles 
from each other, the one without stamens (the male organs), the other 
without pistils (the female organs), bore no seed for many years; but 
when they had risen in height above all intervening and obstructing 
objects, the winds bore the pollen from the stamens of one to the 
pistillate flowers of the other, which immediately began to produce 
fruit. A knowledge of this great law, as applicable to all living 
things, enables horticulturists to raise such varieties of fruit as they 
wish, by shaking the blooming male branch, which has stamens, over 
the female flowers, supplied with pistils. Sometimes the male and 
female flowers are upon the same plant, — at other times, upon differ- 
ent ones. The strawberry is of the latter kind, — the pollen being 
found only on the plants which have the largest flowers, — the pistil- 
lated flowers being only on the smaller plants. The pollen, or dust, 
is carried from the male to the female plant on the feet of honey-bees, 
as they fly from flower to flower. It has been recently discovered 
that the reason why many beds are unfruitful (strawberry beds, I 
mean) is that the large male plants are allowed to monopolize the 
beds to the exclusion of the smaller female plants. The plants with 

47 



870 FEMALE DISEASES. 



large flowers should be thinned out, leaving only a few to furnish 
pollen for the females, which are the real bearers. 

A IVew Branch of Industry, — It is only quite recently that this 
law has been understood in its wide applicability. How wise and 
merciful an arrangement of Providence that an unseen hand should 
turn for man the mystic leaves of knowledge at the very time when 
he is most in need of the instruction imparted I At this very moment, 
the more complete knowledge of this great law is opening a new 
branch of industry and a new supply of food, and is thus helping the 
solution of the great problem of how the increasing inhabitants of 
civilized countries are to be worked and fed. I refer to the propaga- 
tion and culture of fish. 

A committee appointed by the legislature of Massachusetts, in 1855, 
reported very ably upon this subject. It appears that the eggs of the 
fish may be fecundated almost as easily as the pistillate flowers of the 
plant. It is only necessary, when the eggs of the female are mature, 
to hold her over a basin of water, and make gentle pressure upon the 
belly, when the eggs will pass freely into the water ; then to pass the 
milt of the male into the same water, and shake them thoroughly 
together. By this means, the eggs are impregnated, and fish may be 
raised to any extent. 

The egg of the higher animals is more difficult to fecundate, and 
that of the human female, most difficult of all ; for in nature as in art, 
the more perfect structures are begun and reared with less ease. 

Propriety of Imparting this Knowledge. — Men are naturally curi- 
ous, and love to understand the mystery of their own origin ; and yet 
there is scarcely any subject upon which they have so little reliable 
information. It has been held that this is a kind of information 
which it is not proper to impart to the multitude ; that the curiosity 
which seeks this knowledge is based upon improper feelings ; and 
that to gratify it by imparting what is sought, would lead to immor- 
ality. 

I do not believe it. Such ideas are based upon a shallow philoso- 
phy. They overlook the fact that nothing excites the imagination 
like that which is covered with mystery. It is because the immensely 
important subject of the procreation of the race is so carefully hidden 
from the public eye ; because it is purposely buried so deep in obscu- 
rity, that any allusion to it excites improper thoughts. If the subject 
be properly viewed, it is no more indelicate to explain the mode of 
reproducing a human being, than to explain that of propagating a 
plant or a fish. Both are effected in the same way, under precisely 
the same natural law. 

True, the propagation of the human being involves moral laws 
likewise ; but these relate only to the social relations in which it may 
take place, and do not affect in any way the propriety of making it 
understood by the people. 

The Germ Furnished only at Certain Periods. — These general re- 
marks bring me to the immediate subject in hand. Throughout 



FEMALE DISEASES. 



371 




animated nature, the female furnishes the mature germ or egg only 
at certain periods. The healthy human female, — as I have already 
Pjq ^39 explained, — matures a germ 

once in four weeks. These 
germs or eggs are constantly 
advancing, in succession, from 
the rudest beginning, to a state 
of ripeness, or maturity. Every 
person must have seen the eggs 
taken from the hen when killed 
in the laying season. Fig. 139 
furnishes a good illustration. 
They are in all stages of pro- 
gress, from the invisible germ, 
up to the nearly mature egg. 

Such is the progress of the 
human egg, — only that it does 
not attain to any such size. 
So far as the maturing is con- 
cerned, it occurs in the same 
gradual way. 

Conception or Impregnation can take place only when a germ or 
egg is ripe ; and as an egg ripens, bursts, and passes into the fallopian 
tubes leading to the womb, only at the time of menstruation, it is 
plain that conception must happen somewhere in the neighborhood 
of this period. Intercourse with the male may take place at interme- 
diate times ; but, except in some rare instances, conception will not 
occur, because there is no mature egg to be impregnated. 

Now, as every healthy woman brings to maturity a germ or egg at 
the time of every monthly flow, and as every ripened egg is capable, 
under favorable circumstances, of being fecundated, it follows that 
every woman who menstruates, and is well, can, under certain cir- 
cumstances, be impregnated. To effect it, it is only necessary that 
the vivifying portion of the male semen, called spermatozoa, come 
into union with the ripened egg. 

This union (for, that men and women may 
have a chance to know as much about them- 
selves as they do about fishes and plants, I 
propose to make the whole subject plain) takes 
place in the following way. In the act of 
copulation, the male organ penetrates the va- 
gina, and deposits the sperm, spermatic fluid, 
semen, or, as the scriptures call it, the " seed," 
directly at the mouth of the uterine neck. 
Some suppose that when the sensation of the 
female is at its height, the womb opens to 
receive the injected semen. But this is uncertain. 

This spermatic fluid is composed, in a large part, of mucus. A 
smaller portion of it is secreted by the testicles, and is the true semen, 



Fig. 140. 




372 



FEMALE DISEASilS. 



Fig 141 



or life-giving principle. This last portion is composed, almost en- 
tirely, of fertilizing filaments or vesicles, which look like small ani- 
mals (Fig. 140), and for a long time, were supposed to be animalcules. 
They are generally called sperviatozoa. By some mysterious law of 
their nature, they are endowed with the power of motion ; and when 
deposited near the mouth of the womb, they immediately begin to 
move, as if by instinct, in search of 
a ripened egg. Passing through the 
uterine neck, they enter the womb, 
and thence glide onward into the right 
and left fallopian tubes, and through 
these to the ovaries. If an egg be 
found, in its ripened condition, either 
in the womb, or the tubes, or about 
leaving the ovarian bundle, they im- 
mediately embrace it, and, in some 
mysterious way, mingling their own 
fluid contents with the contents of the 
egg^ they impregnate or fertilize it. 
Fifif. 141 shows the womb divided 




lengthwise. A, is the hiiernal mouth __ 

(os internum), or point where the ^HL |J| — = 

canal through the uterine neck enters 
the body of the womb ; B, is the ex- 
ternal mouth ( OS externum) ; the space 
between A and B, the passage through 
the neck ; and C, C, the points where 
the fallopian tubes begin. By looking 
back now, and examining Fig. 134, 
the whole thing will be understood. 

This is a very brief and simple account of impregnation. It is 
supposed to be capable of taking place either a little before or a little 
after the monthly flow, and not at intermediate times, for the reason 
already stated. There are some reasons for believing that the same 
egg or germ, if fertilized just before the courses, will grow to be a 
male, while, if fecundated aftei; the turns, it will be a female. One 
reason for this supposition is, that plants may be made to bear male 
or female flowers by simply subjecting them to different degrees of 
heat. If there be more heat than light, male flowers are produced ; 
if more light than heat, female flowers are the result. The heat of 
the female generative organs is raised to its highest degree about the 
time the egg bursts its covering, which is just before the beginning of 
the flow. 

It has been thought that the right ovary produces males, and the 
left ovary females ; but this theory is not supported by any facts, and 
is probably not trne. 

Causes of Sterility. — From what has been said, it would appear 
that to ensure childbearing, it is only necessary that semen or seed, 
containing spermatozoa, come in contact with a germ vesicle or eggy 



FEMALE DISEASES. ' 373 



at the right time ; that there be no hindering disease ; and that the 
parties cohabiting be adapted to each other. 

It is evident enough that a want of adaptation bet\\^een the parties, 
physical or moral, or both, is often an absolute bar to conception. 
A lack of moral adaptation was probably the obstacle in the case of 
Napoleon and Josephine, — her marriage with a previous husband, 
and his with a subsequent wife having both been fruitful. 

It is certain that indifference on the part of the wife towards the 
husband, and especially repugnance, may prove an obstacle. A mere 
lack of sexual feeling does not necessarily prove a bar, though it 
probably lessens the chances of a fruitful union. 

Conception may fail to take place from the diminutiveness of the 
male organ, — the semen not being deposited in the right place; or, 
from its excessive largeness, — penetration of the vagina being impos- 
sible. In some rare cases, the womb is absent. The inflammation 
of the ovaries often prevents the ripening of eggs. The fallopian 
tubes occasionally get diseased and plugged up, so that no egg can 
pass to the womb. Inflammation in the cavity of the uterine neck 
is probably the most frequent of all the causes of sterility. The 
viscid, gluey matter which is secreted in inflammatory conditions of 
this part, plugs up the passage, so that no spermatozoa can pass up 
in search of the egg. The acrid discharges in most of the cases of 
whites destroy the fertilizing spermatozoa, and render conception im- 
possible. All the displacements of the womb may act as bars to 
impregnation. If it fall over backward or forward, the mouth is 
tilted up before, or down behind, and is not in the right position to 
receive the semen 

Treatment. — Judicious treatment will, in most cases, remove ster- 
ility, and open that " well-spring of pleasure," which the poet has so 
felicitously described as — "a baby in the house." 

The obstacles to conception, stated above, are chiefly those diseases 
which had been previously described. To cure those diseases, is to 
remove the obstacles. When it is dependent on the causes which 
produce painful menstruation, or profuse menstruation, or a suppres- 
sion of menstruation, the remedies are the same as are pointed out 
for those complaints. If inflammation of the ovaries be the cause, a 
cure may be effected, provided the inflamed condition be removed 
before the bundle of eggs be destroyed. If inflammation or ulcera- 
tion of the neck of the womb be the obstacle, the remedy may be 
found in the treatment recommended for those affections. 

Sterility depending on the causes just mentioned, I have had the 
pleasure of curing many times. "When dependent on a lack of phys- 
ical or moral adaptation between the parties, it does not, of course, 
admit of relief. It is a misfortune to be borne in silence. It has 
happened, perhaps, through a lack of judgment or care in selecting 
a partner, and is one of the mistakes of a lifetime which a lifetime 
cannot repair. When this want of adaptation is not complete, a rem- 
edy may frequently be found. 

Unfortunately, many females do not regard sterility as an evil to 



374 FEM.VLE DISEASES. 



be deplored, but rather as a blessing to be desired. Life, to them, 
has no high aims or duties, — it is a round of fashion and pleasure. 
To bear and reaf children interrupts their frivolities, and they seek to 
escape such abridgment of their pleasures. This is wrong. Life is 
a great theatre, in which all should strive to act some worthy part, 
and feel that, upon retiring, it would be wrong to leave their garments 
upoQ the vacant stage, with none to put them on, and continue the 
drama. 

Case. — In 1854, a lady, twenty-five years of age, was brought to 
me by her husband, in the hope that some relief might be obtained 
for some female complaints, from which she had suffered for a num- 
ber of years, and which threatened to make a wreck of her health, if 
not to destroy her life. 

Having come with the full purpose of having the case properly in- 
vestigated, both herself and husband readily assented to an examina- 
tion, which revealed a highly inflamed and swollen condition of the 
neck of the womb, with a small ulcerated patch immediately around, 
and extending some half inch within the cavity. She had for a long 
time suffered severe pain at her monthly turns, with great and dis- 
tressing bearing down both before and after her menstrual flow ; her 
back was weak and painful, making it impossible to walk out of 
doors, or to stand much upon her feet. She had become nervous 
and much debilitated, and had pains at times in her chest, her liver, 
her head, and limbs ; was distressed by all sorts of disturbances of 
the stomach ; and had become, as she said, about as thoroughly un- 
fitted for all the useful purposes for which human beings are made, 
as she well could be. 

She had been married five years ; but, as might be expected from 
the condition of the uterine neck, she had no children. 

Introducing a glass speculum, I took a caustic holder, with a piece 
of stick nitrate of silver in it, and touched the whole surface of the 
ulcer in the mouth of the womb as far as it could be reached. I di- 
rected her to take one to two teaspoonful doses of the tincture of 
scullcap every night, to quiet the nerves and promote sleep, and re- 
quested her to come to me again in a week. 

At the next visit I reached the upper part of the ulcer in the uterine 
neck with a delicate silver syringe, and threw a fine shower of a 
strong solution of nitrate of silver upon all sides of the ulcer, and 
prescribed, in addition to the scullcap, pills of iron, etc. (75), to be 
taken three times a day. 

I directed her to see me once a week, which she did for four 
months. The improvement, after the second week, was gradual and 
steady, — so much so, that little variation was required in the treat- 
ment. At the end of four months, the inflammation and ulceration 
had both disappeared; her pains and aches had all silently with- 
drawn ; she could walk, ride, and stand upon her feet ; and, in brief, 
she has since, to the delight of herself and husband, borne two chil- 
dren, and enjoyed tolerably good health. 



FE^l^VLE DISEASES. 375 



Midwifery. 

A STOPPAGE of her courses is most commonly the first notice a 
woman has of her being in the family way. This is perceived two 
or three weeks after conception, when she begins to experience other 
feelings peculiar to the situation. These feelings are nausea and vom- 
iting; or a decided languor, in the morning ; swelled and sometimes 
painful breasts ; the areolas, or colored rings around the nipples darker 
than usual ; pain in the lower part of the back ; and, occasionally, a 
good deal of spitting of a frothy, cotton-like substance. 

These symptoms are more or less severe in different cases, and 
under different circumstances, according to the state of the patient's 
bowels, and her habits of exercise. Ordinarily, she suffers most 
during the second and third months, on account of the 

Sinking Dotiti of the Womb, which, from soon after the period of 
conception, is gradually increasing in size and weight. As it grows 
larger and heavier, it sinks lower in the cavity of the pelvis, until 
about the fourth month, when, becoming so large that it cannot longer 
be accommodated within the narrow limits of this unyielding box of 
bones, it is obliged to mount higher to find room in the ampler and 
more distensible belly. This low position of the womb in the early 
months of pregnancy, occasions many disagreeable sensations, — as 
pain in the lower part of the back, and sickness at the stomach. 

The Costiveness, too, from which women suffer so much at this 
time, is often caused, in part at least, by the pressure of the enlarged 
womb upon the lower bowel. Costiveness, thus induced, at length 
becomes itself a cause of serious mischief. The lower bowel, filled 
and enlarged with its hardened contents, reacts upon the womb, 
crowding it still lower in its narrow quarters, and greatly increasing 
its excitability. The enlarged bowel and womb combined, make 
constant pressure, sometimes upon the urethra, or water-pipe, causing 
pain and difficulty in making water, and alivays upon the ascending 
veins, checking the return of blood, and producing congestion in the 
lower bowel, manifested by troublesome piles. 

Treatment of Preg'nancy. — When the pregnant woman first recog- 
nizes her situation, she should determine to "observe moderation in 
all things." Let her avoid violent and sudden exertion, and move 
about more calmly and evenly than usual. By this is not meant that 
she should give up her customary occupation ; but that she should 
pursue it with becoming carefulness, resolved in no case to hazard 
over-exertion, and rather leaning to the side of indolence. This 
would not be reo2 indolence^ for she is doing a great work iniernally^ 
and should not unduly withdraw her energies to external affairs. 

Let her not be too much in the erect position. If of delicate 
constitution, and not in vigorous health, she should make it a point 
to lie down several times during the day. The standing poi^ition, 
continued for a long time, especially if it be under circumstances 



376 SKIX DISEASES. 



to induce fatigue, greatly favors the descent of the womb, — while 
a frequent rest in a horizontal position, may enable it to keep its 
place. 

All Objection. — It may be objected by some, that a large majority 
of the mothers in the world are working women, and obliged to con- 
tribute by their industry to the support of their families ; and that 
they cannot aflbrd, therefore, to lie still, and mind directions. 

To this it may be answered, that it is a great advantage to under- 
stand the best way, so as to have the privilege of at least aiming at 
it. Much is accomplished, in all circumstances, by aiming at doing 
the best thing ; and few women are so situated that they could not 
so favor themselves as to obey the laws of health a little more per- 
fectly, if they thoroughly understood them. All can better afford to 
avoid sickness, than to be sick. Many occupations, also, unless 
money tempt to excessive application, become, when steadily fol- 
lowed, comparatively easy and unexciting. Thus, most people can 
go through their usual round of duties, because they have got used 
to it. Indeed, there is nothing but indolence itself, to which we may 
not become accustomed. The difference between the laboring and 
the privileged classes is more imaginary than real. All must work. 
None can escape the primeval decree — " In the sweat of thy face 
shalt thou eat bread." 

Many women, when they find themselves in the family way, will 
observe no cautions, but work all the harder, and even use other 
means for the purpose of bringing on abortion, and preventing an 
increase of children. This unnatural and wicked, but too prevalent, 
disposition, results sometimes from a fear of the pains of child-birth, 
sometimes from a desire to avoid the necessary care and confinement 
connected with raising children, but most often from a wish to escape 
the expenses which the prevailing fashions and customs of society 
connect with a large family. The cost of a shattered nervous sys- 
tem, and of a body weakened and poisoned by powerful drugs, is not 
considered, because not understood I Hence the success of those 
quack advertisements, impudently professing to cure female diseases, 
but whose chief object is disclosed by the insertion of the hypocritical 
caution — "Be careful not to take this medicine during pregnancy, as 
it will be sure to produce abortion.^^ 

It seems as if the world would never learn that God loves children, 
although since Abraham's day he has said so much about them in 
his word, — although His Son, sent into the world on purpose to 
show the disposition of the Father, took them up in his arms, and 
blessed them, — and although He has implanted a most wonderful 
love of them in the soul of man. 

Costiveuess and Piles. — Let the pregnant woman use all proper 
means to keep her bowels in order. She will thus greatly diminish 
the distressing nausea, and may entirely prevent the accession of 
piles. To accomplish this object, the saline aperients (7) (5), or, oc- 
casionally, other mild cathartics (10) (12) (14), may be used. Bat 
more important than either or all of these is the frequent use of a 



FE^DSXE DISEASES. 377 



good self-injecting family syringe. An injection of half a pint of 
cold water every morning, will do much towards regulating the 
bowels, and preventing or curing piles. 

Xausea. — If, as sometimes happens, there should be persistent 
nausea after the first three months, it will need to be combatted 
by mild tonics and stimulants, as chamomile tea, or clove tea (58) 
(114), and by seeking a kind of diet which will be agreeable both 
to the palate and the stomach. Dr. Meigs speaks of champagne 
as a remedy, and mentions some serious cases entirely relieved 
by it. 

The Xipples. — During the last month, particular attention should 
be paid to the nipples. Untold misery often results to the young 
mother from sore nipples ; and it is well worth her while to use every 
precaution against them. The nipples are of course in an excitable 
state during the whole period of gestation, and at length frequently 
become ir-ritable and tender. Let them be daily bathed, for three or 
four weeks before confinement, with some astringent and cooling 
lotion, as oak-bark decoction, borax water, alum water, or a solution 
of tannin (200) (201) (202) (203). 

The object of treatment, in this case, is to toughen them, and ren- 
der them less susceptible, so that they may not be made tender by the 
subsequent application of the child's lips. 

When a woman is peculiarly liable to this trouble, the further pre- 
caution of having them gently drawn, by some friend, every day, 
during this last month, would be of great service. 

At all events, let no pains be spared to guard against this evil ; for 
sore nipples make sore breasts; and sore breasts make broken breasts; 
and broken breasts are terrible things. They make the mother sick; 
and if the mother is sick, the child is sure to be sick ; and all hands 
soon get sick and worried ; and the whole business of having children, 
and taking care of them, is deprived of its peculiar joys and consola- 
tions, and brought into undeserved disrepute. Whereas, under wise 
and prudent management, there is something delightful to the young 
mother in yielding sustenance to her dependent offspring. For, when 
her nipples and breasts are in a healthy state, she can say with the 
poet, as 

" The starting beverage meets its thirsty lip, 
'T is joy to yield it, as 'tis joy to sip." 

Swathing. — In advanced pregnancy, much assistance in supporting 
the burden is sometimes derived from swathing the bowels. Healthy 
and vigorous women, however, need no such assistance ; it is chiefly 
applicable to cases of debility, either constitutional, or resulting from 
neglect, or from over-exertion during former pregnancies. 

Cramp in the Stomach is sometimes very severe, and if allowed to 
continue, may kill the child. The best remedies are warm carmina- 
tives (114) (115), or anodynes, etc. (121) (122), or antispasmodics 
(90) (94). 

48 



378 FEMALE DISEASES. 



Ileadaclies. — These may be relieved by antispasmodics, etc. (90) 
(94), or anodynes (121). 

Palpitation of the Heart may prove very distressing to delicate 
women. The remedies are the antispasmodics, with rest. Some- 
times tonics are useful, such as the muriated tincture of iron (73). 
The bowels should be carefully regulated. 

Fainting, which occurs before or at the time of quickening, is some- 
times very troublesome. The proper treatment is the avoidance of 
fatigue, and, during the fainting fit, the recumbent posture, cool air, 
application of cold water to the face, and ammonia to the nose. 

Cough is sometimes present. It is caused by the upward pressure 
of the diaphragm against the lungs, by which they are irritated and 
convulsed. The remedies may be selected from the cough prepara- 
tions among the prescriptions. 

Taricose Veins, — These cannot be removed during pregnancy; but 
they may be relieved by great care of the bowels, and by wearing 
tight bandages, or elastic stockings. 

Swelling of Lower Limbs is caused by pressure of the enlarged 
womb upon the veins ; and may be relieved by care of the bowels, 
and diuretics (130). 

Itching of the Genitals may be much relieved by borax, morphine, 
etc. (204). 

Miscarriage.— Abortion. 

When a woman in the family way throws off the contents of her 
womb, or loses her child, during the first six months, the accident is a 
miscarriage, or abortion ; when the same thing happens daring the 
last three months of her term, it is a premature labor. 

Symptoms. — If abortion occur during the first month after concep- 
tion, the symptoms may not attract much attention, or, may be re- 
garded only as an irregularity of menstruation. Occuring at later 
periods, it is frequently indicated by some feverishness, coldness of 
the feet and legs, a pufFed-up condition of the eye-lids with purplish 
discolorations, shooting pains in the breasts, which become soft, pains 
in the back, bearing-down pains in the lower part of the bowels, 
which come and go, and at length take the character of real labor 
pains. As these pains increase, blood begins to appear, and, sooner 
or later, the bag of water breaks, and the fetus is thrown off. 

Causes, — These are very numerous. Some of the principal are, 
displacement of the womb ; ulceration of its neck ; syphilitic disease 
of the fetus received from the parent ; too much exercise ; heavy lift- 
ing ; falls, particularly when the woman comes down upon the feet, 
and is heavily jarred; emetics; powerful purges; and too much nup- 
tial indulgence. 



FEM^VLE DISEASES. 379 



Treatment, — Where the symptoms are but slight, nothuig may be 
required more than a little caution for a few days, and rest in the 
horizontal posture, using cold drinks, and taking for two or three 
nights, at bedtime, perhaps, a pill composed of one grain of opium 
and two grains of sugar of lead. Beside these remedies, it may be 
well to put a mustard poultice low down upon the back. 

If, notwithstanding, flooding comes on, and the sym])toms of mis- 
carriage increase, a napkin wetted with cold water, or vinegar and 
water, or a bladder partly filled with ice, should be laid upon the ex- 
ternal genitals, and pulverized alum, mixed up with a little honey, 
must be given internally, every half hour ; and if the flooding stiii 
increase, it may be proper in some cases to resort to the tampon or 
plug. To do this, take either lint, or old pieces of calico, or a piece 
of fine sponge, and having soaked it full of a strong solution of alum, 
or tannin, or, still better, Monsel's persalt of iron, one part to six 
parts of water, — fill the vagina full, and then place a fold of linen in 
the genital fissure, and apply a bandage. This will generally stop the 
flow ; but the plug must be removed in from five to ten hours. 

If the abortion cannot be prevented, — especially in the latter 
months of gestation, then the case is to be permitted to go on, and to 
be treated the same as a natural labor. 

Labor.— Delivery. 

The expulsion, at full term, of the child, the after-birth, the mem- 
branes, and the fluids, constitutes labor, or delivery. It is supposed 
to occur about two hundred and eighty days after the last menstrua- 
tion ; but authors reckon it differently ; in truth, it is not possible to 
fLX it exactly, for it evidently varies in different cases. 

When the time of her lying-in arrives, let every woman meet it 
with calmness and undoubting confidence. There is every reason to 
encourage this state of mind. Think of the vast multitudes of people 
in the world. Each one once existed in the womb of a mother, and 
had to pass through its narrow portals to be admitted to the light. 
Successful delivery is the rule, the world over ; and it should be the 
rule to confidently expect it. 

In the midst of the pains of labor, nothing does more to bring a 
favorable result than courage and patience. Patience is able calmly 
to survey all the difficulties before her, because she never attempts to 
encounter but one at a time. There is much philosophy in the story 
of the " discontented pendulum,^'' which got discouraged, one morning, 
from reflecting how many millions of times it would have to swing 
during succeeding years, but became reassured upon considering that 
a single stroke cost but a very trifling effort, and that it really had to 
make hut one at a time. So it is with labor ; its pains, which are 
really severe and agonizing, will become comparatively tolerable, if 
the whole attention of the woman be confined to present suffering, 
and her whole stock of courage and patience be brought to bear upon 
one pang at a time. 

Let her resist the temptation to a feeling of haste. Nature will 



880 FEMALE DISEASES. 



often proceed more evenly, and more speedily, if allowed to take her 
own time. A hurry to get through is a great obstacle to successful 
delivery ; it always puts things back. 

Sjinptoms. — One of the first indications that labor is about to 
begin is, that the woman finds herself smaller^ — the child having 
sunk down lower in the abdomen, and she accordingly breathes 
easier. The genital organs become relaxed and moist, and mucus 
escapes, which is called " the shows." The woman finds herself dis- 
posed to be nervous and fidgety, and perhaps a little depressed in 
spirits. 

When labor has fully set in, it is marked by lowness of spirits, 
flashes of heat and cold, a great desire to empty the bowels and to 
make water, and grinding, cutting pains, which grow stronger and 
more continuous, with intervals of ten or fifteen minutes' ease be- 
tween. Vomiting in the early stages of labor often occurs, and may 
be regarded as favorable, — indicating the softening and opening of 
the mouth of the womb. 

Treatment of Labor. — When labor begins, the attention should be 
directed to the state of the bowels and bladder. The child's head 
begins early to press upon the bladder and lower bowel, causing the 
desire to make water, etc. ; and these should be immediately emptied 
to make room for the head to pass more easily. Thp bowel may be 
freed by a dose of castor oil (10), if there is time for it to operate, — 
but more surely, and more satisfactorily, by an injection. Relief in 
the bladder may, perhaps, be obtained by a different position of the 
woman in the act of making water. It is the pressure of the child's 
head upon the water-pipe which causes the trouble ; and to relieve it, 
the woman should get upon her hands and knees, with her shoulders 
lower than the hips, so as to throw the child upward and forward 
towards the cavity of the abdomen. Thus situated, she may often 
find it easy to make water, when in the ordinary position it would be 
impossible. If, however, this manoeuvre does not succeed, and the 
bladder becomes greatly distended, the catheter must be used. 

The Bed and Habiliments. — In the next place, fix the bed, and 
the patient's habiliments. Reject feather beds ; use the mattress. 
Cover this with a rubber cloth, if convenient, and then with folded 
sheets to absorb the discharges, and protect the bed. Let the woman 
be arrayed in the same garments she expects to wear after the com- 
pletion of the labor, and let these be well tucked up under her arms, 
and let the lower portion of her body, from the waist downwards, 
be enveloped in a sheet. This sheet can be easily removed, and the 
clean clothes pulled down without greatly disturbing the patient when 
in the exhausted state which follows labor, and when it would subject 
her to great fatigue to be obliged to sit up in bed to have her clothes 
changed. Let her lie upon her left side, with her body shortened by 
bending forward, so that the muscles may be relaxed ; let her head be 
placed in the middle of the bed, and her feet press against the right 
foot-post. Around this post a shawl or towel may be fastened, upon 
which she may be allowed to pull during the pains. 



FEMALE DISEASES. 381 



The l^reseutiition. — An examination with the finger is to be made 
to learn the presentation, — that is, to learn which part of the child 
comes first into the mouth of the womb. 

Head Pi'esentatioii, — If the head present, the labor will probably 
go on without the need of medical aid. But in all labors there is a 
fiability to dangers from unforeseen accidents, which renders the at- 
tendance of an intelligent physician highly prudential. 

Breecli or Feet Presents tioii. — If the feet or breech present, it is 
desirable to have the first part of the labor proceed slowly, so that 
the passage may become well dilated, and prepared for a more rapid 
delivery of the head. If the breech present, do not pull down the 
feet ; let the child come double : it will make more room for the head. 
If the feet present, let there be no pulling upon them to hasten the 
birth of the breech. 

After the feet and breech have fully cleared the external orifice, 
the delivery may be judiciously hastened for the purpose of prevent- 
ing the death of the child from pressure on the umbilical cord, before 
its head is brought to the air, and the act of breathing thus permitted. 
For after the pulsations of the cord cease, the child must either 
breathe or die. 

In this kind of presentation, therefore, the child's life is in great 
danger. After the birth of the lower half of the body, the cord ex- 
periences severe pressure, sufl^icient to interrupt if not wholly prevent 
its pulsations. It then becomes necessary to hasten the birth of the 
upper extremities and head by all prudent means. Violence is never 
in order in midwifery; but considerable force, skilfully directed, may 
sometimes be safely used. After the shoulders are delivered, the pas- 
sage of the head may be facilitated by carefully pulling down the 
arms. Then, as soon as possible, introduce the finger into the mouth 
of the child. This will serve the double purpose, perhaps, of per- 
mitting a little air to make its way into the child's lungs, and of fur- 
nishing a hold by which its head may be gently drawn along into the 
world. 

If there is much delay at this juncture, perhaps in some cases the 
child's life may be preserved by inserting into its mouth one end of a 
male catheter, — thus furnishing an open tube for the passage of air, 
until more vigorous pains shall introduce it into the full liberty of the 
atmosphere. While the head is yet undelivered, great care should be 
used to keep the child's body warm by covering it with flannel, and 
also to keep it in a correct relative position with the head. If the 
body be incautiously turned round, of course the neck will be twisted ; 
and the child's subsequent delivery with a broken neck will be the 
miserable result, — bringing confusion to the medical attendant, and 
unhappiness to all concerned. 

Arm or SliouMer Presentation. — If the arm or shoulder present, 
the child will probably have to be turned. In case this cannot be 
effected, its chest must be opened and emptied of its contents, that 
there may be room to bring down the head. It is barely possible to 
avoid a resort to art in this presentation. 



382 FEMALE DISEASES. 



Flooding or Hemorrhage, occurring to an alarming extent, is hap- 
pily one of the rare incidents or consequences of labor. But when it 
does occur, it demands the most serious and prompt attention. 

Profuse bleeding from the womb is most commonly owing to a 
partial separation of the placenta, or after-birth, from its attachment 
to the internal cavity ; and it has recently been observed that the flow 
proceeds more rapidly from the detached portion of the after-birth 
than from the corresponding exposed surface of the womb. A knowl- 
edge of this fact has an important practical bearing ; for if, in severe 
cases of flooding, the partially detached after-birth can be entirely 
separated, the bleeding will often be speedily arrested. 

The most dangerous floodings occur in cases of placenta previa^ 
when the after-birth is over the mouth of the womb. In such cases, 
when the labor commences, and the womb begins to open itself, the 
after-birth must of course be partially separated. These cases, unless 
promptly relieved by art, may prove fatal in a few minutes. Yet, 
there is ordinarily sufficient time, if it be improved, calmly to choose 
and pursue the proper treatment. If the flooding be immediately 
dangerous to life, the child must be turned and delivered, or the 
tampon or phg be applied, as directed under the head of abortion. 
This expedient is used when, through rigidity of the mouth of the 
womb, the delivery is inadmissible. 

Before Delivery. — In all cases of flooding, we prescribe quiet, the 
recumbent posture, cold applications to the abdomen and the external 
genitals, and the internal administration of astringents and anodynes 
(152). 

After Delivery, our object is to promote contraction of the womb 
by «old applications and frictions externally, or, if necessary, by the 
introduction of the hand into the womb, for the purpose of removing 
the after-birth, clearing out clots, or stimulating it to shut itself up for 
the expulsion of the offending substance. Until this contraction is 
secured, the plug should not be used, lest internal bleeding into the 
enlarged and expanded womb should be profuse, and fatally exhaust 
the patient. 

After the Child is Born, our first duty is, if possible, to see that it 
breathes. In the vast majority of cases, the well-known cry, which 
salutes the ear, gives proof that the duty is unnecessary. But some- 
times we fail to hear this welcome sound. The umbilical cord may 
be once or repeatedly wound around the child's neck, and must be 
immediately removed to prevent strangulation ; or, the child's mouth 
may be filled with phlegm, or some sticky mucus, which must be 
poked out with the finger, and its exit favored by turning the face 
downward ; or, after tedious labors, the child may be born in a very 
feeble state, and may need the stimulus of cold water thrown sud- 
denly, in small quantities, upon its chest and body, with considerable 
rubbing, and perhaps the inflation of its lungs with air blown into its 
mouth. 

Tying the Cord. — When breathing is established, a piece of narrow 



FEMALE DISEASES. 383 



tape or common twine is to be tied tight around the navel-string, 
about two inches from the child's navel, and the cord is then to be 
cut off, with a pair of sharp scissors, from half to three quarters of 
an inch outside the place where it is tied. The child is then to be 
delivered to the nurse. 

Washiiio' the Cliild. — The child is now, while the physician is at- 
tending to the mother, to be washed and dressed by the nurse. Its 
skin is at this time covered with a suet-like substance, called the 
vei'tiix caseosa. To remove this, it should be washed all over gently 
with warm water and castile soap. It is not material that this coat- 
ing should be absolutely all removed at the first washing ; but the 
soap and water should be again gently applied in eight or ten hours 
from their first use. It is improper to use spirits for this cleansing. 
All rough rubbing must be avoided as injurious to the delicate skin 
of so tender an infant. Washing with cold water would lower the 
temperature to a dangerous degree, and should in no case be allowed. 

Removal of the After-Birth. — The woman having rested fifteen or 
twenty minutes, a little gentle soliciting or pulling with the cord will 
generally bring away the after-birth. If, however, any serious obsta- 
cle prevent its expulsion, it may be slowly and cautiously taken away 
by the hand introduced. 

Cleansing the Bed, and Applymg the Swathe. — Upon the removal 
of the after-birth, a cloth is immediately applied to the external or- 
gans, a drink of water or tea is administered, and another rest of an 
hour or more allowed. The woman may then be conveyed to a 
neighboring bed, sofa, or easy-chair, for the purpose of cleansing the 
bed, adjusting her clothes, and applying the swathe. This last men- 
tioned application may consist of a towel pinned snugly around the 
body, or of a cloth, cut and fitted exactly for the purpose. Its object 
is to afford a firm and steady support to the contracting womb. 

If a chair is occupied while the bed is being arranged, it should be 
well tipped back, and the woman's feet supported on a high stool, as 
it is of great importance, so soon after delivery, to keep her either 
entirely or very nearly in the recumbent posture, to avoid dangerous 
floodings. 

The Dressing's for the Child's Navel should be so fixed that the 
navel-string or cord will not be left in contact with the healthy skin. 
To effect this, make a hole large enough to admit the cord in the 
centre of a piece of linen cloth four inches square ; pull the cord 
through this hole, leaving the cloth lying flat upon the child's belly ; 
then, having bandaged the cord down to the belly, fold the cloth over 
it, and apply the belly-band. The interposition of these dressings 
will thus keep the cord, which is dead and in process of decomposition, 
from irritating, and perhaps excoriating the jiving flesh, with which it 
must otherwise be in close contact. 

Nourishment of the Child, etc. — After being dressed, the child 
should be kept next the body of the mother or nurse, that it may 



384 FEMALE DISEASES. 



receive the natural warmth thus to be derived. Its nourishment 
should be obtained exclusively from the mother's breast. If it is 
hungry, be sure and keep it so. There is nothing more appropriate 
than a hungry child all ready to take hold and exhaust the full and 
almost bursting breast on the third day, when the milk has come. 
Alas ! How many children have been fed on sweetened water, and 
on milk and water, till they have lost all instinctive idea of, and all 
appetite for, nursing ! and how many bowel complaints and broken 
breasts have been the miserable consequence ! But meddlesome 
friends are afraid the '• little dears " will starve ; and therefore they 
must first be made sick by unnatural diet, and then for their cure be 
treated to that filthy, harsh, and indecent substitute for medicine, 
" chamher-lye and molasses^ 

But it may be asked, " must not the child be fed at all, if it is hun- 
gry, and cries a great deal, and there is nothing in the mother's breast 
for it ? " Such cases will be exceedingly rare, if the breasts have 
been properly solicited from the first by a hungry child. When they 
do occur, being themselves exceptions, their treatment must be ex- 
ceptional ; but, even then, only so far as is absolutely necessary. If 
fed at all, the child should not be fed to satiety, but as little as the 
circumstances will possibly permit. The great rule remains : keep the 
child as hungry as possible till the milk comes. When it has to be 
fed, imitate the mother's milk as nearly as possible in the preparation 
of the artificial diet. A little sweet cream, warm water and sugar, 
should be so mingled, that in warmth, richness, and sweetness, the 
mixture may closely resemble human milk. 

Diet of the Mother. — For the first few days after confinement, the 
most appropriate diet for the mother is gruel, cocoa, rice-water, crust 
cofiee, or some similar*" liquid nourishment. Difierent constitutions, 
however, need somewhat different management. 

A woman naturally robust, and of full habit, should confine herself 
more strictly, and for a longer time, to this light diet, than one who 
is more slender and feeble. In some cases, weakly women require 
the juice of meat, and even wine or ale, as early as the second or third I 
day. If she be subject to canker, or nursing-sore mouth, a generous I 
diet is particularly serviceable. After the first week, she may gradu- | 
ally return to her customary diet. ' 1 

Costiveness may be treated with the usual remedies. It was an I 
old rule to give a dose of castor oil on the third day, when there is a i 
little increase of excitement in the system, from the filling of the I 
breasts. This is not always necessary, and in most cases an injection 
would be far better. 

The Perpendicular Position — During the first month, let the woman 
avoid being often or long on her feet. This is a very essential caution | 
to avoid prolapsus, or falling of the womb, with all its attendant weak- 
nesses and pains, and to ensure a good " getting up," with a sound 
womb, in the right place, and subsequent months of health and enjoy- 
ment. 



FE^IALE DISEASES. 385 



Milk Le^. — Phlegmasia DoJens. — Crural Phlebitis. 

The popular idea is, that in this disease the woman's milk has fallen 
into her leg, which has inflamed. This is of course absurd. As to 
the real nature of the complaint, there are various opinions, — some 
holding it to consist in inflammation along the sciatic, crural, and 
pubic nerves ; others, that it is an inflammation of the lymphatics of 
the groin which causes it ; others, that it is an inflammation of the 
crural veins. Probably this latter view is the correct one. 

Symptoms. — The disease begins in from two to seven weeks after 
delivery, with pain in the lower bowel, groin, or thigh. The pain is 
more violent when the thigh is extended. In a day or two, the pain 
diminishes, and the limb begins to swell, frequently in the calf of the leg 
first, thence extending upward, but generally in the groin, and extend- 
ing gradually down. The skin becomes entirely white, smooth, and 
glossy, does not pit when pressed, is painful to the touch, and is hotter 
than the skin upon the other limb. In connection with this local 
disease, there is general fever, with small and rapid pulse, thirst, etc. 

Treatment. — The patient must lie flat upon her back, with the 
swelled limb placed upon pillows, or a bolster, raised so that the foot 
shall be a little higher than the hip, and then charged not to put her 
foot down upon the floor, until she is very nearly well. 

Apply a narrow blister along the course of the crural vein. When 
this is removed take a large piece of flannel, — Dr. Meigs says an old 
flannel petticoat, with the hem and the gathers cut off", — and dip it in 
vinegar and hot water, equal parts; wring it out, and cover the whole 
limb with it. Put a piece of blanket or oiled silk over it to keep it 
from wetting the bed. Repeat this, and keep it up for six hours. 
When it becomes tedious to the patient, remove it, and bathe the 
limb w^th warm sweet oil, two parts, and laudanum, one part, and 
cover it with flannel. In two or three hours, return to the first appli- 
cation of hot water and vinegar. Continue this for five or six hours, 
and then take warm sweet oil and laudanum ; and thus pass from 
one to the other until the inflammation is subdued, or, as Dr. Meigs 
says, till the calf of the leg can be shaken. 

If the bowels are confined, let them be gently moved by some gen- 
tle physic (13) (14) (18) (25) (27) (41). 

In many cases, diuretics and cathartics combined will be proper 
(302), or diuretics only (128) (130). 

While the inflammation lasts, and there is fever, the tincture of 
veratrum viride must not be forgotten. 

If recovery does not take place after the active inflammation has 
subsided, the limb should be bandaged from the toes to the groin. 

Child-Bed Fever. — Puerperal Fever. 

Few complaints more justly excite the dread of the practitioner 
than this. It cuts down woman at a time when she can least of all 

49 



386 FEMALE DISEASES. 



be spared by her young offspring, and at a moment when she most 
excites the love and sympathy of her whole family. It is a terrible 
disease. 

It consists of inflammation of the peritoneum or lining of the ab- 
domen ; also, frequently inflammation of the ovaries, of the womb, 
of the veins of the womb, or of the absorbent vessels of the womb. 

Its symptoms have already been described, on page 277, under the 
head of inflammation of the peritoneum. The treatment is, likewise, 
there given. I may mention here, however, that an infusion of cham- 
omile flowers is lately spoken of as a powerful means of preventing 
suppuration in this complaint. 

There is a diversity of opinion as to whether this disease is conta- 
gious, though the best medical testimony seems now to be on the 
affirmative side of the question. The physician or midwife having a 
case of child-bed fever in charge, should not for some time attend 
cases of midwifery. 

Nursing Sore Mouth. 

Nursing women sometimes suffer terribly with this complaint. It 
begins with a scalding sensation upon the tongue, a pink color in the 
roof of the mouth, and a hot, watery discharge from the mouth. 
After a few days, small ulcers appear on the tongue, and in the 
throat. Costiveness is generally present ; but when the ulceration 
extends to the bowels, diarrhoea occurs. It comes to an end upon 
weaning the child. 

Treatment, — To relieve costiveness, give some gentle cathartic (12) 
(15) (25) (34) (36). 

Iron in some of its forms and combinations is highly necessary (61) 
(71) (73) r349). 

Gargles\vill frequently do much good (227) (229) (230) (235) (243) 
(244) (347) (350). 

rThe diet must be simple, nourishing, and digestible, consisting of 
stale bread, potatoes, tender beef steak, roast beef, broths, etc. 

Inflammation of the Breast.— Broken Breast. 
Mammary Abscess. 

The mammary gland, or gland which secretes milk in the human 
breast, consists of a number of ducts, passing inward from their ter- 
mination in The nipple, and then spreading around like the roots of a 
tree, and terminating in minute glands. The mammillary tubes are 
straight ducts, ten or twelve in number, having their mouths at the 
centre of the nipple, dilating at its base into larger reservoirs, which 
extend some distance into the gland. (Fig. 142.) 

When milk is first formed, after confinement, these tubes and res- 
ervoirs sometimes get so full and hard that they crowd and compress 
each other, making it difficult to remove the milk, and under these 
circumstances, the breast will inflame. 



FEMALE DISEASES. 



387 



Fig. 142. 



Symptoms. — Tlie inflammation generally begins with a chill, fol- 
' lowed by fever, and pain of a shooting kind, which is much increased 
by pressure. An examination will generally reveal 
a circumscribed, hard, and painful tumor, even be- 
fore there is any redness on the surface. After a 
time, the swelling spreads, the skin becomes of a 
dusky red, is hot and shining, will frequently pit a 
little on pressure, and soon gives a sense of fluctua- 
tion. Upon the formation of matter, the fever is 
increased, the breast is enlarged, and there is local 
tenderness and throbbing pain. 

This complaint may be caused by taking cold, 
irregularities in diet, or by mental emotion ; but 
more commonly it is caused by accumulation of 
milk within the ducts. 




Treiltmeilt. — These afflictions may generally be 
prevented by keeping the breasts well drawn. It is the duty of a 
nurse to look well after this matter, and see that the breasts do not 
get hard and distended with milk. 

But when the inflammation has fairly set in, the first aim should 
be to prevent, if possible, the formation of matter. 

Active purging should be resorted to at once (29) (32). Sweating 
should be encouraged by the tincture of veratrum viride. If the 
object be to prevent the formation of matter, cold lotions, or cold 
water compresses, should be used freely ; but if two or three days 
have passed before active treatment, the suppuration will go on, and 
it is better to use warm applications. Dewees says warm vinegar is 
the most beneficial as well as the most comforting. Poultices and 
warm fomentations are much used. Some apply stimulating lini- 
ments, made of essential oils, etc. (195) (198). Leeches are often 
used with advantage. They should be applied, not upon the breast, 
but just below it. 

During the progress of the disease, especially after the abscess is 
opened, the breast should be supported, and prevented from hanging 
down, by long strips of adhesive plaster carried below and around it. 
By this means a gentle pressure is kept up by which the matter is 
more easily evacuated. 

The breast should be opened with a lancet as soon as the abscess 
points, or fluctuation is discovered. Should the ulcer not heal, an 
astringent wash, as a weak solution of nitrate of silver (211) may be 
applied to it once or twice a day. 

During the discharge of matter, the system of the patient should 
be supported by a nourishing diet, and by wine, tonics, etc. 

Sore Nipples. 

Women suffering from excoriated nipples are apt to keep the infant 
chiefly to the healthy breast, and only to apply it to the tender side 
for the purpose of obtaining present ease from the pain of over-dis- 



388 FEMALE DISEASES. 



tension. In this way the ducts remain always full, and are apt to 
get inflamed. Sore nipples, therefore, are to be attended to as much 
on account of the evils to which they lead, as of the suffering they 
directly occasion. 

The excoriation of the nipples begins as a chap. This shows no 
tendency to heal ; and the child's mouth being often applied, rubs off" 
the skin around the crack, and this naked surface soon becomes an 
ulcer. These ulcers are sometimes only on the surface ; at other 
times they are profound, going deep into the substance of the nipple. 

Treatment. — These excoriations and ulcers might be easily healed, 
were it not that the newly-formed skin is apt to be continually rubbed 
off by the child's mouth in the act of sucking. Two things are there- 
fore to be done, — to favor the healing, and to protect the tender part 
from renewed injury. 

For the first object, a strong infusion of green tea or port wine may 
answer very well in ordinary cases. A little alum or borax, dissolved 
in rose water, or water (201) (202), is often used. A weak solution 
of sulphate of zinc, or sulphate of copper, or nitrate of silver (209) 
(211). But one of the very best articles is composed of glycerine and 
tannin (306). 

To protect the teat from injury in the act of sucking, use a shield 
made of India rubber. When the infant is not at the breast, the 
nipple should be covered by a metal shield. 



CARE OF CHILDREN AND THEIR DISEASES, 



l*iire Air. — The first want of a child is a plenty of fresh air ; and 
this want never ceases to the end of life. Impure air kills thousands 
of infants. Out of 7,650 born in the lying-in hospital of Dublin, 
2,944 were destroyed by impure air within two weeks after birth. 

Children should be kept in the open air as much as possible, and 
in well-ventilated rooms when indoors. It is wrong, when infants are 
sleeping, to cover their faces with bed-clothes, or draw curtains around 
their cots, or to envelop their heads in blankets and shawls when 
carried in the open air. 

The Skin. — The health of infants requires that their skin should be 
kept clean. Unless this is done they are liable to suffer much from 
cutaneous and other diseases. The skin of a new-born child is cov- 
ered with a white, unctuous matter, called the vernix caseosa. It is 
injurious to let this remain for any length of time after birth. To 
remove this. Dr. Dewees recommends that the child be smeared with 
hog's lard, and then washed with soap and water. Dr. Eberle says, 
smear with yolk of eggs, and then wash with simple warm water. 

The young child should be washed every day with warm water, — 
then, after a time, with tepid water, then with temperate, and finally, 
after it is some months old, with cold water. This, if persevered in 
through childhood and youth, will ward off" a thousand ills and sick- 
nesses to which the young are liable. 

Tlie Clothing of Children should be so adjusted as to give their 
limbs ample play, and should be thick enough to keep them warm. 
They ought to have flannel next the skin in winter, and cotton in 
summer. At the risk of wounding some nice people's feelings, I 
must add that the fashion of a child's clothes is not important. 

The Food. — The natural and proper food of a young child is its 
mother's milk. To this it should be confined, unless prohibited by 
imperative circumstances, until a portion of the teeth are cut. When 
the mother cannot nurse her child, the breast of a suitable nurse 
should, if possible, be supplied. If the infant need any more food 
than is supplied by the breast, give cow's milk and water, sweetened 
with a little loaf sugar. The sucking-bottle, if used, must never be 
permitted to get sour. 



390 CARE OF CHILDREN AND THEIR DISEASES. 

Healtli of a Nursing* Woman. — During nursing the greatest atten- 
tion to Health is required by the mother or the nurse. A woman of a 
consumptive constitution should never nurse an infant. Nourished 
at the breast of such a mother, the child, who has inherited her con- 
stitution, will be the more likely to fall a victim to her disease. 

Passions of a Nursing Woman. — Let the woman who nurses a 
young child be careful of her passions. An irritable disposition, giv- 
ing rise to gusts of violent passion, may so alter the character of the 
milk as to throw the child into convulsions. Grief, envy, hatred, fear, 
jealousy, and peevishness, unfit the milk for nourishing the child, and 
often cause the child's stomach to be much disordered. 

The Diet of the Nurse should receive strict attention. It should be 
plain and wholesome, and the amount should never be excessive. 
Her drink should be simply water. She should take gentle daily ex- 
ercise in the open air. 

Weaning. — At the end of twelve months, the first set of teeth are 
generally so far cut that the child can manage most kinds of plain 
food ; and it may now be taken from the breast. Should the teeth 
appear earlier, and the infant be healthy, it may be weaned even at 
the end of the tenth month. Never take the child from the breast in 
the midst of summer heat. A disordered state of the bowels, or 
cholera infantum, would be likely to be the result. The spring and 
the autumn are the proper periods for weaning. 

If for some months, it have been accustomed to other food beside 
the milk of the mother, it may be taken suddenly from the breast. 
It must not have any amount of solid food it may crave immediately 
after weaning. It should still be kept, for some time, upon a simple, 
bland, half-fluid aliment, taken in moderate quantities, and at proper 
intervals. At first, the food should be bread and milk, boiled rice and 
milk, soft-boiled eggs, roasted potatoes and milk, oat-meal gruel, plain 
rice pudding, preparations of arrow-root, tapioca and sago, simple 
meat broths, mixed with crums of bread or grated crackers, or in 
which rice or barley has been well boiled. From this it may pass 
gradually to a more solid diet ; though, until the age of puberty, the 
principal part of the diet should be milk, the farinaceous articles, and 
vegetables. Sugar has been thought to be injurious to children. It 
is not so. If taken moderately, at meal times, it is wholesome. 

Whatever be the food allow^ed to children, it should never be taken 
in excess ; and to prevent this, they ought not to take their meals alone ; 
for they have very keen appetites, and if permitted to do so, they will 
generally form habits of gluttony. Three or four light meals a day is 
enough. 

Their drink should be water simply, — nothing else. 

If parents would observe these rules, and enforce them strictly, they 
would confer blessings upon their children greater than riches. They 
would send them into the world with health and good constitutions, 
and would save them from untold misery and an early death. Such 
a course would evince more love for their children than those weak 



CARE OF CHILDREN AND THEIR DISEASES. 891 

concessions which allow tea and coffee, and all sorts of food, in quan- 
tities to suit, which occasion early disorders of the stomach and 
bowels, and bring later derangements of the nervous system, with 
all its regrets and horrors. 

Sleep of Children. — During the first period of its existence, an in- 
fant sleeps a large portion of the time. This is a wise provision of 
nature. It withdraws the young child, for a time, from those outward 
exciting agents, which would too much disturb the nervous system of 
so tender a being. Whenever a young infant is restless or wakeful 
much of the time, we may feel sure it has had too much food, or is 
in some way disturbed by it, or by tight clothes, or that some other 
cause is giving it uneasy sensations. 

Its sleep should be the promptings of nature, and should never, 
except in rare instances, be brought about by opiates. It is wrong 
and sinful for a mother or nurse to put an infant to sleep with an 
opiate, merely that she may gain time for pleasure, or even for other 
duties. 

The Infant slionld be kept warm while Sleeping. — During the first 
few weeks it should sleep with its mother, — especially if the weather 
be cold. After that, it may be in a cradle or cot. The covering should 
be warm, but lis^ht, so as not to press heavily upon its tender limbs. 
If laid upon its back, the fluid of its mouth and throat may get into 
the windpipe, and obstruct the breathing, or produce coughing. It is 
better, therefore, to lay the infant upon its side, — taking care not lo 
produce distortion of the spine or limbs by always laying it upon the 
same side. 

Children should not be allowed to sleep either with the aged, or 
with sick persons. It is not healthful for them to breathe the exhala- 
tions from the bodies of such. For a somewhat similar reason, some 
kinds of plants, and flowers generally, should be excluded from their 
sleeping rooms. Their beds should be so placed as to turn their faces 
away both from the sun-light which comes in at the windows, and 
from the artificial light in the room. 

They should be taught to retire early at night, and to rise imme- 
diately after waking in the morning. This habit will be worth much 
to them through life. After the meconeum has passed, the bowels of 
an infant should be opened from two to four times in twenty-four 
hours. K the stools are less frequent than twice a day, or, if they are 
lumpy, some gentle cathartic is called for. From half a dram to a 
dram of fresh castor oil, or a dessert-spoonful of mixture (24) an- 
swers a good purpose. During childhood, the bowels should be moved 
once or twice a day. When a cathartic is required, a table spoonful 
of mixture (25), or a teaspoonful of (17), will be found very excel- 
lent. 

Exercise. — During the first few weeks of an infant's life it requires 
but little exercise ; indeed its organization is not sufficiently settled 
and compacted to permit much without injury. A little gentle rub- 
bing with the hand over the whole body, is about all it needs or will 



392 CARE OF CHILDREN AND THEIR DISEASES. 

bear. To dandle and toss it about, and especially to set it upright, is 
injurious and wrong. Its bones are all soft, and will not endure to 
be much twisted about, and its spine is not stiff enough to bear up 
the weight of its head. 

After a few weeks, riding in a carriage drawn by a careful and 
trusty nurse, is both a healthful and pleasurable exercise for children. 

Learnino' to Walk. — At the end of the ninth or tenth month, a 
child may begin to learn to walk. It is not safe to teach it this exer- 
cise much earlier than this, as the bones, being soft, may be bent by 
the weight of the body, and the limbs be permanently deformed. 

As soon as the child has learned to walk alone, it should be allowed 
perfect freedom of exercise. Thenceforward, the open air is its proper 
place during the day ; and such an unrestrained use of its limbs as 
its own instincts may dictate, is its proper calling. For five years 
after it has learned to walk, it should do little else than to use its 
limbs out of doors, as it pleases. The books and the school-room 
will be in season after that. First compact the body, — then bring 
out the mind. The mind is of no use without the body, — the body 
must be developed first, or never. 

Moral Treatment, — We charge upon nature many of the bad pas- 
sions which we ourselves implant in children. The moral treatment 
of children is generally bad. We are apt to begin by either making 
them our masters or our slaves. Sometimes we do both, — allowing 
them to govern us for a time, and then, getting into a passion, or a 
mood for playing the tyrant, we turn upon, and govern them as if we 
were autocrats. We submit to their whims until we grow irritable, 
and then, by way of retaliation, we compel them to submit to ours. 

This is all wrong. Children should be governed always^ but with 
an even, a gentle, and a loving hand. They should early be subjected 
to habits of self-control, and of regularity in eating, and sleeping ; and 
should be taught absolute and continued obedience. All this can be 
brought about only by firmness, self-control, and great gentleness on 
the part of the parents. If they would make a child cheerful and 
happy in its disposition, they must themselves be cheerful, and never 
let it see anger, passion, and fretfulness, marring their conduct. 
Nothing is more injurious to the health of a child than a peevish, 
complaining, and soured disposition; and these vices are seldom ac- 
quired, unless seen in the lives of parents. 

How to Nurse Sick Children. 

As the education of the young, whether religious, moral, or intel- 
lectual, is more important than that of adults, so is the care of their 
physical life of more importance. Death aims to " out- Herod Herod," 
and seeks the life of all infants, male and female, and in fact destroys 
one half of all below the age of five years. 

But few know how to train and take care of children. It is a still 
more rare gift to know how to nurse them when sick. No persons 



CARE OF CHILDREN AND THEIR DISEASES. 303 

can properly nurse sick children who are in feeble health, or have 
fretful tempers, or are low-spirited ; for they can neither endure the 
fatigue, nor bear the trials, nor hear the prattle which such a respon- 
sibility would bring. Some will manage a well child very well, who 
are not fit to have the care of a sick one ; for there is a great differ- 
ence between a child when well, and the same child when sick. 
When well, and full of fun, and frolic, and life, laughing, and jump- 
ing, and shouting aloud for very joy at being alive, it is an easy thing 
for a person of even a morose temper to attend upon them. But 
when sickness comes, and the child's playfulness is all laid aside ; 
when it becomes so fretful that nothing goes right with it ; when it 
cj-ies to be laid down, and then cries to be taken up ; stretches out its 
hand for drink, and pushes away the cup when it is presented, — 
apparently made more angry by your attempts to serve it ; — when 
these things are repeated, day and night, until the nurse is weary and 
exhausted, and even a change of disease and amendment only brings 
a cross aixl fractious temper, it is only by possessing peculiar qualifica- 
tions, that the nurse can maintain an even and unruffled disposition. 

While passing through such scenes, it is hard for the nurse to re- 
member that sickness does not destroy the little loving heart, but only 
hides its affection for a short time. 

Signs of Disease in Children. — It is important that the nurse of 
sick children should know what to observe, and the meaning of the 
signs of disease. A baby has only cries to express its sick feelings. 
To one person, these cries mean no more than that the baby has some 
sort of illness. To another, with more experience and better powers 
of observation, they point to the head, or chest, or stomach, as the 
disorder. A baby with the stomach-ache, utters long^ loud, and pas- 
sionate cries, and sheds tears plentifully. Suddenly it stops for a mo- 
ment, and then begins again, — drawing up its legs to the stomach, 
and as the pain passes off, stretching them out again, and with many 
sobs, passing off into a gentle sleep. 

If there be inflammation in the chest, it neither cries aloud, nor 
sheds tears, but after every long breath, or hacking cough, it utters a 
short cry, which is cut off before it is half finished, — apparently be- 
cause crying is painful. 

If the disease be in the head, the cries will be sharp, piercing shrieks, 
ivith low moans and wails between. Or, there will be quiet dozing, 
interrupted by startling pains. 

When a child is taken ill, whatever the disease which is impending, 
there is always a change of some sort, which soon attracts attention. 
It either loses its appetite, or is fretful, or soon tired, or sleepy, or 
restless, or thirsty, or has a hot skin, or, rather, has a number of these 
symptoms. It vomits, or is purged or bound in its bowels. It loses 
its merry laugh and cheerful look ; it no longer watches its mother's 
or its nurse's eye, as before, but clings to her more closely, and wiU 
not be out of her arms a moment. If lulled to sleep in her arms, it 
wakes immediately on being placed in its cot. 

Such symptoms often continue a day or two before it can be de- 

50 



394 CARE OF ciiiLDrvEX a:>i) their diseases. 

termined what disease is impending. An intelligent nurse may do 
much towards solving the question. It is frequently proper at such 
times to place the child in a warm bath. When stripped for the bath, 
it should be carefully examined to see if there is any rash upon its 
body. If it be a rash from which it is about to suffer, the bath will 
help bring it out. The rash should be looked for at least every twelve 
hours, until the nature of the disease is determined. 

The Appearance of tlie Different Raslies may be distinguished with 
a little care and experience. Measles has a number of dark red spots, 
in many places running into each other, and is generally seen first 
about the face, and on the forehead, near the roots of the hair, and is 
preceded by running at the eyes and nose, and all the signs of a 
severe cold. Scarlet fever does not show separate spots, but presents 
a general bright red color of the skin, much like a boiled lobster. At 
fu'st there is more of it about the neck and chest than on the face, 
and it is preceded by a sore throat. Chicken pox is attended by 
fever, but not so much running at the nose and eyes as in measles, 
nor is there so much cough. The spots, too, are smaller, and are not 
so much run together ; and they come out more over the whole body. 
They appear a few hours earlier on the body than elsewhere ; and in 
a day or two they are found to be enlarged, and turn into little blad- 
ders of water as big as the head of a shawl-pin. 

And now a few Words as to what should be Done in the sick-room 
of a child. The room should be kept cool^ and its temperature should 
be measured by a thermometer. This instrument, when hung away 
from the fire, should show a temperature of about do°. That is about 
the right degree of warmth. Sick-rooms are generally kept too hot. 
The room should be darkened ; not made totally dark, but its light 
shaded down by closing the outside blinds, or by dropping the cur- 
tains, so as to give a kind of twilight; and the cot should always be so 
placed as to turn the little one's face away from the light. The room 
should be kept quiet ; and this requires attention in the whole house, 
as well as among the persons in the room. Those present should 
never whisper, but speak in low and gentle tones, — should not walk 
on tip-toe, but move about carefully. There is di fussy quietness which 
disturbs the sick far more than noise. The child must be spoken to, 
and roused from its slumbers, and turned from side to side, and raised 
for its food or medicine, with a soothing tenderness, and a delicacy 
which never forgets itself. 

In applying leeches or cold to a child, judgment is needed, to suc- 
ceed well. The leeches should be put either behind the ear or on top 
of the head, so that the child cannot see them. Cold is best applied 
by means of a couple of bladders half filled with powdered ice, and 
wrapped in two large napkins ; one of them should be placed under 
the child's head, the corner of the napkin being pinned to the pillow- 
case to prevent its being disturbed, while the other is allowed to rest 
upon the head, with the corner of the napkin again pinned to the 
pillow, to take off the greater part of its weight. In this way the child 



CARE OF CHILDREN AND THEIR DISEASES. 395 

will not be wetted, or irritated, as by the changing of wet cloths, 
nor will the cold applications get displaced by its movements. 

A word should be said respecting the nursing of children in cases 
of lung-intlammation, — an aftection from which they often suffer. 
The lungs are much like two large sponges, and the air enters them 
through the windpipe ; and passing through smaller and yet smaller 
tubes, it comes at last into tiny cells, so small that they can only be 
seen by a magnifying glass. When the lungs are inflamed, some of 
the tubes become stopped up ; and the very small cells are pressed 
on by the flow of more blood than natural to the part ; and so the 
air enters less easily, and in smaller quantities, than it should. If 
now you let the child lie flat, it is not only less able to draw a deep 
breatli, and fill the lungs, but the blood also flowing to the inflamed 
portion of the lung, returns less easily than if the child were propped 
up in bed. When a whitlow is on the linger, if the hand be hung 
down, the inflamed finger will become redder, and will beat and 
throb so as hardly to be endured, while, if the hand be raised, the 
pain will abate. The same increase of pain does not follow an accu- 
mulation of blood in an inflamed lung, because the lung is not as 
sensitive as the finger; but the consequences are very serious. The 
air-cells being more and more pressed upon, the admission of air is 
more and more difficult, until, at length, a large part of the lungs is 
rendered useless, and the child dies. 

In this disease, the temperature of the room needs attention. The 
air should not be quite so cool as in other diseases. From 60° to 65"" 
is about right. 

Of course crying will irritate inflamed lungs, and it is all important 
that a child sick with this disease should be soothed and quieted as 
much as possible. Every good nurse knows how to do this better 
than any rules can teach her. 

Sometimes sickness and vomiting, from which a child may suffer, 
are increased by want of judgment in giving food and drink. When 
there is nausea, the stomach will bear only very small quantities of 
food at a time, while cold drinks are almost always borne much bet- 
ter than warm. When there is nausea, it is best, for an hour or two, 
not to attempt to give any food or drink. After the stomach has been 
thus completely rested, give a single teaspoonful of cold water. If 
this is not thrown up, it may be succeeded, in ten or fifteen minutes, 
by a second or a third. If this is borne, give a little water thickened 
with isinglass, or cold barley water, or cold milk and water ; and 
then, with the same precautions, and in very small quantities, beef 
tea, or chicken broth, or whatever else the doctor in attendance may 
direct. The smallness of quantity, the coldness of the articles, and 
the giving it without moving or disturbing the child, if possible, are 
the important points to be attended to. 

It is of great consequence that children suffering from diarrhoea 
should have their skin kept very clean. The pores should be kept 
well open, so that the fluid matter which is passing off by the bowels, 
and through the mucous membrane or inner skin, may be diverted to 
the outer skin. In this disease, the skin of children is apt to become 



396 CARE OF CHILDREN AXD THEIR DISEASES. 

irritable, or even sore. In these cases, soap and water are quite apt 
to increase the soreness, while a little starch, made as for use upon 
clean clothes, though much thinner, will, if used in place of soap, very 
much soothe the inflamed skin. 

A child much exhausted by diarrhoea, or other disease, should be 
moved or lifted out of its cot or cradle as little as possible. Suddenly 
moving it when very weak, may cause fainting, or even convulsions. 
Let it be sponged and cleaned by merely turning it, with great gentle- 
ness, from side to side. 

In such cases, too, the child should be supported with proper nour- 
ishment. When worn down by diarrhoea, its desire for food may be 
nearly lost. Though at one time it cried much, and seemed to suffer, 
it will, in this condition, grow quieter, and doze, and even sleep on 
for hours, appearing fretful only when roused. If, in such cases, the 
child be allowed to go without food because it does not seek it, or 
declines it when offered, it will sink into a deeper and deeper sleep, 
and finally into a stupor which will end in death. To give a little 
arrow-root, or wine, or broth, may now require trouble and persever- 
ance ; but it must be done, for upon it depends the child's life. The 
effort to administer food must not be abandoned because once or 
twice, or several times unsuccessful, for the food which is refused one 
minute, may be accepted five minutes after. 

In the various rashes from which children suffer, there is a very 
general fear of washing the surface lest the rash be driven in. There 
is no ground for this fear, unless it be in measles ; and even in this 
complaint, there is no danger if luke-warm water be used. If only a 
small part of the body be sponged at a time, there is nothing to fear 
even from frequent washing ; and the passing of a wet sponge fre- 
quently over the surface is a great comfort when the skin is burning 
with fever. The same remark applies to the changing of the linen. 
The same kind of objection, and with no better reason, is often urged 
against cold water in fevers, though it is most refreshing, and if 
taken in small quantities, and often, never does harm, but often much 
good. 

The AVarm Bath. — The best method of giving a child a warm 
bath is a matter of importance. There should be as little parade 
about it as possible. K the child sees the bath prepared, is taken out 
of bed, undressed and put into it smoking before its eyes, it may be 
much alarmed, and cry so passionately as to be really injured by it. 
The bath should be prepared out of its sight, and brought to the bed- 
side with a blanket spread over it to hide the steam. The child 
should then be laid upon the blanket, and gently let down into the 
water, and then set to play with a couple of corks with feathers stuck 
in them. 

Inflammation of the Mouth. — Erythematic Stomatitis. 

This is a simple inflammation of the mucous membrane of the 
mouth ; and is very common during infancy. It may be confined to 
the tongue, or spread over the whole mouth. It is sometimes very 



CARE OF CHILDREN AND THEIR DISEASES. 397 

severe, going down into the gullet and stomach, and into the wind- 
pipe. It occasions redness and pain in the mouth, and fretfulness of 
the infant, — causing it to quit the nipple suddenly when sucking. 
A frequent result of this inflammation is the secretion and exudation 
upon the surface, of a white, matter-like curd. It appears in small 
points and patches. This is the thrush, or what nurses call children's 
sore mouth. It is commonly confined to the period of suckling. 

Treatment. — For the simple inflammation of the mouth, a wash 
made by infusing the inner bark of slippery elm in water, answers a 
good purpose ; and in more severe cases, a wash made of sugar of 
lead (^-7) will be found useful. 

In some mild cases of curdy exudation, this last wash will do well, 
if united with the daily use of the warm bath, and proper care of the 
diet. But in the more severe cases, a little pulverized borax and 
white sugar or honey (274) (275), placed occasionally on the infant's 
tongue, will do good service. A decoction of equal parts of blue 
cohosh and golden seal is a good remedy. When the curdy patches 
are large, touch them with a mixture of hydrochloric acid and honey 
(276). If the exudation have a look as if mortification were taking 
place, use a wash of chloride of lime (228), or chloride of soda, etc. 
(229), or creosote and mucilage (230), or alcohol and vinegar (231), or 
nitrate of silver (211). When diarrhoea is present, with acidity, give 
(26). In the more severe cases, when appearances of mortification 
are seen, quinine (69) should be administered. 

Follicular Inflammation of the Mouth. — Apthce. 

This disease attacks the little glands of the mouth, called follicles, 
and appears about the time of cutting teeth. Small white specks, a 
little elevated, first show themselves on the lips, insides of the cheeks, 
and under side of the tongue, etc. The specks enlarge, a whitish, 
curdy matter flows out from their centre, and ulcers are formed, with 
elevated edges, surrounded by a red, inflamed circle. Sometimes, 
instead of curdy matter, a bloody exudation takes place, and dark- 
colored crusts are formed which are mistaken for mortification. In 
bad cases, there is great restlessness, with hot mouth, dry skin, thirst, 
and diarrhoea, with green stools, and sometimes salivation. 

Treatment. — The milder forms of this disease are treated like 
simple inflammation of the mouth. If there is thirst, give several 
times a day, a spoonful of cold water, with a little gum arable dis- 
solved in it. If the child be weaned at this time, its food should be 
barley or rice-water, sweetened with loaf sugar. An occasional dose 
of magnesia, with or without a little rhubarb, will remove the acid 
which abounds in the bowels. After ulceration has taken place, 
borax (274) will do well. When watery discharges from the bowels, 
and griping pains appear, preparation (28) should be used. If the 
strength be reduced, give (69). 



398 CARE OF CHILDREN AND THEIR DISEASES. 



Inflammation of the Gums. — Gengivitis, 

During the cutting of teeth, the gums are apt to be inflamed, red 
or livid, swelled and painful. The child is languid, with a hot and 
dry skin, small and quick pulse, little appetite, much thirst, and a 
tongue covered with a thick, yellowish fur. When ulceration takes 
place, and is allowed to go on, the teeth become loose, black, and 
rotten, and often soft and pulpy ; a flow of fetid spittle takes place ; 
the breath of the child becomes offensive, and its countenance pale 
and sallow. The gums bleed under the least pressure, and a profuse 
diarrhoea fills up the list of ills. 

Treatment, — In the first stages, mild washes to the gums, such as 
(227), will do well. Clear out the bowels once with magnesia and 
rhubarb (26). After ulceration has taken place, use oak bark (232), 
or chloride of lime (228), or diluted hydrochloric acid (233). A daily 
tepid bath. If the strength be reduced, use an infusion of Peruvian 
bark, or quinine (69), 

Gangrene of the Mouth.— Canker. — Cancrum Oris. 

This disease attacks weakly children, of a lymphatic temperament, 
and having inflamed gums. It often follows intermittent, remittent, 
or bilious fever, and is also frequently connected with disease of the 
stomach and bowels. 

Sjniptoms. — It is attended with languor, listlessness, indisposition 
to play or move about, thirst, loss of appetite, peevishness, and ina- 
bility to sleep. The countenance is pale and sunken, and there is a 
peculiar puckering of the cheeks about the corners of the mouth. 
The breath is bad, the gums have the appearance of salivation, the 
teeth become loose and fall from their sockets, or, if they remain, they 
become covered with a thick coating of a dirty white or ash color. 
A few ash-colored water pimples appear upon the gums, which en- 
large, run together, and finally break, — presenting a black appearance 
of mortification. The gangrene, sooner or later, goes to the lips and 
cheeks. 

Treatment. — When bowel complaints exist, they are to be treated 
with the usual remedies, such as (70) or (156). If there be active 
inflammation of the gums, at first, leeches may be applied, after 
which, the inflammation being subdued, a wash of oak bark (232), 
will be in place, with quinine given internally (69) to ward off the 
mortification. As a wash, too, a strong solution of sulphate of cop- 
per (234) is excellent, — so is white vitriol (235), and nitrate of silver 
(219), and creosote (236). 

The diet should be beef-tea, plain beef or mutton broth, with rice, 
milk and rice, tapioca, sago, and the like. 



CARE OF CHILDREN AND THEIR DISEASES. 399 



Difficult Teeth-Cutting. 

Teeth-cuttixg generally begins between the ages of five and seven 
months. It is indicated by redness, heat, and tenderness of the gums, 
an increase of saliva, and, occasionally, redness of the cheeks, water- 
ing of the eyes, thirst and fever, with fretfulness, disturbed sleep, and 
more frequent motions of the bowels, a little more fluid than usual, 
and sometimes of a greenish hue. As the tooth comes near the sur- 
face, the child holds its fingers in its mouth, and presses the gums 
harder upon the nipple when sucking. Beside these milder symp- 
toms, there are sometimes ulceration of the mouth, gangrene, exten- 
sive and long-continued diseases of the bowels, — and even disorders 
of the brain, convulsions, and palsy. 

Treatment. — Watch the gums, and the moment they are swollen 
by the teeth pushing them up, lance them at the elevated points, cut- 
ting entirely down to the advancing teeth, — so that no tough mem- 
brane shall cause pain by impeding their growth. These incisions 
often prevent fatal disease of the brain, and sometimes almost in- 
stantly relieve the most threatening symptoms. Before the teeth are 
far enough advanced for lancing, some soothing wash may be applied 
to the gums, or a leech or two to the angle of the jaw. For obsti- 
nate diarrhoea, with watery stools and griping, use prescription (157). 
If the child be drowsy and starts from sleep, and has heat and red- 
ness, with enlargement of the blood vessels about the head, put three 
or four leeches behind the ears, and make cold applications to the 
head. At the same time, open the bowels with castor oil (17). 
When there is difficulty of passing the water, give flax-seed tea ; and 
if the pain be considerable, an opiate (351). 

Croup. 

This is one of the scourges of childhood. In ten years previous 
to 1845, no less than 1150 children were destroyed in Philadelphia by 
croup. During the year 1840, the large number of 4,336 died of the 
same disease in England. 

Croup is an inflammation of the mucous membrane of the larynx 
and windpipe. It causes to flow out upon the surface of the mem- 
brane, a peculiar fluid, which stiffens into a membrane, or skin-like 
substance, and adheres to the inner surface of the wind-pipe, and 
sometimes extends through the whole of the bronchial tubes. This 
is membranous croup, — the worst and most fatal form of the disease. 
Dr. John Ware of Boston has shown that there are other forms of 
croup, not so fatal, because not attended by the formation of a mem- 
brane upon the mucous surfaces. 

The Symptoms of croup are, difficulty of breathing, hoarseness, and 
a peculiarly loud and ringing cough, with fever. In the membranous 
and worst form of the disease, the breathing is not, at first, so labo- 
rious, and the symptoms generally not so violent and alarming as in 



400 CARE OF CHILDREN AXD THEIR DISEASES. 

the less fatal but more inflammatory type. This latter kind, though 
generally causing great alarm, like a highway robber, by the sudden 
fierceness with which they seize the throat, are yet much less fatal, 
and of course less to be feared, than the membranous form. The 
disease is pretty much confined to children between the ages of one 
and eight years. 

Treatment. — The old and usual mode of treatment is first to bleed, 
and then to place the patient in a warm bath ; and, after the child is 
returned to the bed, to give nauseating doses of tartar emetic (105). 
In Boston, this treatment is now nearly discarded, as being too active, 
and possibly a cause of evil rather than good. The following is a 
safer and more successful treatment. 

Give, every three hours, Dover's powder and calomel (352). Sponge 
the neck often with water, and apply a liniment (192). It is some- 
times proper to give a gentle emetic, — say, two drams of wane of 
ipecac. A flax-seed poultice applied to the neck is also excellent. If 
the child be large enough, let it inhale frequently from an old tea-pot, 
the vapor of hot water and mullein leaves ; and if it be too young to 
do this, keep the room full of watery vapor, by throwing water upon 
hot bricks. If the bowels need moving, give a dose of castor oil (17). 
In addition to these measures, a strong solution of nitrate of silver 
(219) should be thrown into the throat with one of my laryngeal 
shower syringes, and repeated every two hours till the membrane is 
discharged. 

Spasm of the Glottis. — Laryngismus Stridulus. 

This disease consists in a sudden shutting up of the glottis, or pas- 
sage to the windpipe, which creates a feeling of strangulation, and a 
difficulty of breathing so great that the drawing in of the breath 
causes a peculiar crowing sound. There is no fever. The child, upon 
taking food or drink, or upon being irritated or teased, is taken sud- 
denly with an impossibility of drawing in its breath. After struggling 
convulsively for a timiC, its head thrown back, its nostrils dilated, its 
mouth open, its eyes rolled up, its face pale, its legs and arms stiff", 
it begins to breathe with a shrill crowing sound. The disease is 
sometimes mistaken for croup, and for hooping cough. It is strictly 
spasmodic in its nature. 

Treatment. — During the paroxysm, set the child in an upright pos- 
ture, with the head leaning forward, exposed to a full draft of cool, 
fresh air, and sprinkle cool water upon the face. Let nothing be tight 
about the neck. Slap the child slightly on the back, and apply fric- 
tion along the spine. If these means do not succeed, place it in a 
warm bath ; while in the bath, sprinkle cold water on the face. 

\Vhen the fit is over, examine the gums. If they are swollen, lance 
them down to the coming teeth. The bowels should be moved daily 
with some gentle physic, but not irritated by severe purging. If the 
stools are light colored, use prescription (142), with warm water in- 
jections. 



CAKE OF CHILDREN AND THEIR DISEASES. 401 



Hooping Cough. — Purtussis. 

This is a contagious disease, peculiar to childiiood, and occurring 
but once in the same individual. It is characterized by a convulsive, 
paroxysmal cough, which is attended by long-continued hissing, con- 
vulsive breathing, with rattling in the windpipe, which is succeeded 
by several short efferts to expel the breath, following each other in 
quick succession. The long, convulsive breathing, attended by the 
hooping sound, is immediately repeated ; and these paroxysms con- 
tinue until a quantity of thick, slimy, ropy mucous is thrown up, by 
expectoration or vomiting, when the breathing is again free. These 
paroxysms have all the appearance of impending suffocation, redness 
of the face, shedding of tears, sweating about the head and forehead, 
and such agitation of the whole body that the child lays hold of 
something for support. Blood sometimes starts from the nostrils, 
and the cliild involuntarily passes water, or evacuates the bowels. 
In spring and autumn, the disease most prevails. It is not generally 
dangerous. 

Treatment. — First give an emetic, — say, two drams of wine of 
ipecac. Afterwards, give small doses of ipecac and sulphur (277). 
From six to fifteen grains of sulphur alone, three times a day, is an 
excellent remedy. A liniment of olive oil, oil of amber, etc. (193), 
applied to the spine, is useful. Belladonna (278) is a good remedy. 
Prussic acid (96) is strongly recommended by many, and is worthy 
of a trial. Lobelia (106) is a valuable remedy. Alum (279) is well 
recommended. Sulphuric ether, a little being spilled in the nurse's 
hand and held to the child's nose, generally shortens the paroxysm, 
and frequently abridges the disease. A solution of nitric acid in 
water, as strong as lemon juice, and sweetened, is a very valuable 
remedy, — breaking up the disease in two or three weeks. The child 
may drink it freely, a little further reduced with water. 

Looseness of the Bowels. — Diarrhoea. 

Infants and chilhren are more liable to diarrhoea than adults, and 
this is the reason for speaking of the disease here as well as else- 
where. It may be caused by inflammation of the stomach and 
bowels, by irritation produced by too much or improper food, by cold 
and damp weather, or by teething. The discharges from the bowels 
may be more or less thin, of a dirty-white color, of a curdled appear- 
ance, and acid smell, or they may be watery, yellow or green in color, 
and often mixed with blood. Sometimes they are mixed with por- 
tions of undigested food, are very acid, and when the looseness has 
been caused by unripe vegetables and fruit, in a state of fermentation, 
like yeast. At other times, especially while teething, they are a kind 
of thick mucus, like jelly. 

If pressure on the bowels causes pain, the diarrhoea is the result of 
inflammation. When the disease has become chronic, the skin is dry, 

51 



432 



CARE OF CHILDREN AND THEIR DISEASES. 



harsh, and discolored, the face wrinkled, looking yellowish, dirty, and 
old. 

Treatment. — First, regulate the diet. This is very important. In 
the case of older children, take away every kind of solid food, as well 
as pastry, confectionery, sweetmeats, and fresh vegetables. Give 
plain boiled rice and milk, — sometimes boiled milk, — water gruel, 
crackers and milk, tapioca, etc. At the beginning of the attack, give 
some mild physic, as castor oil, or syrup of rhubarb. A warm bath 
at this period is excellent. If the discharges are very sour, dissolve 
a teaspoonful of bicarbonate of soda in half a tumbler of water, and 
give a teaspoonful every hour, or the same amount of lime water, 
mixed with an equal quantity of new milk, or prepared chalk and 
ipecac (158), some slight astringent being used also (159). But bet- 
ter than all other astringents for this complaint, is a decoction of the 
cranesbill or spotted geranium, with milk, or of the bark from the 
root of the common blackberry which is armed with strong prickles. 



The Summer Complaint of Infants. — Cholera Infantum, 

This is confined to the North American continent. It occurs in 
large cities during the hot season. Its subjects are infants between 
the ages of four and twenty months, — occurring most frequently 
about the time of cutting the first teeth. It is one of the most fatal 
diseases of infants. 

Symptoms. — It begins with a profuse diarrhoea, — the stools being 
green or yellow, or more often light colored, and very thin. The 
stomach soon becomes very irritable, — rejecting everything with vio- 
lence. In some cases, vomiting and purging set it, — the discharges 
from the bowels being without color or smell. The infant rapidly 
loses flesh, and is soon reduced to great languor and prostration. 
The pulse in the beginning is quick, small, and often tense. The 
tongue is covered with a white, slimy mucus. The skin is dry and 
harsh. The head and belly are hot. The feet and hands are either 
of the natural temperature, or cold. There is great thirst, and tow- 
ards evening, fever. The belly is often a little swollen, and tender to 
the touch. Occasionally there is delirium, as indicated by wild and 
bloodshot eyes, violent tossing of the head, and attempts to bite and 
scratch the nurse. 

Treatment. — If possible, remove the child at once from the impure 
and heated air of the city to the cooler and purer air of the country. 
If this cannot be done, keep it in as large and dry a room as can be 
had, and take it often into the open air, in clear weather. Confine 
the infant entirely to the breast, or, if weaned, let its food be tapioca, 
pure arrow-root, rice flour, and milk, and put it daily in a warm or 
tepid bath, according as the skin is hot or cold. Give it gum-water, 
or rennet whey, with a little gum arable added to it. 

These measures, if used early, will often cure the disease, without 
medicine. If the vomiting be obstinate, camphor and sulphuric ether 



CARE OF CHILDREN xVXD THEIR DISEASES. 403 

(*2S0) will generally give relief. When everything else fails, in re- 
lieving the sickness, sugar of lead (160) is generally successful. 
AYhen the vomiting is stopped, the most prompt remedy for the dis- 
ordered bowels is the compound syrup of rhubarb and potassa. 
When the disease has become chronic, treat it the same as children's 
diarrhoea. But if the discharges are sour, offensive, and dark colored, 
pulverized charcoal (42), with tartrate of iron (71), will be suitable 
remedies. Rhubarb, leptandrin, etc. (28), will often answer a good 
purpose. 

Colic. 

Infants are very much subject to colic, from over-feeding and eon- 
sequent acidity of the stomach, from giving them solid food at too 
tender an age, and from some improper thing ate or drunk by the 
mother or nurse. They often suffer intensely from these pains, toss- 
ing their legs up and down, and screaming vehemently. When it 
arises from costiveness, the bowels are often hard and swollen. 

Treatment. — W^hen it arises from costiveness, give an injection of 
a tablespoonful of castor oil, and an ounce of warm infusion of pep- 
permint or spearmint. At the same time, administer internally an in- 
fusion of one of the same herbs, with a small portion of bicarbonate of 
soda dissolved in it, and sweetened with loaf sugar. Or, if the bowels 
need to be acted upon, the syrup of rhubarb, or the sweet tincture of 
rhubarb, with a little soda in it, will do well. Paragoric generally 
brings relief, but should not be used, if simple carminatives will an- 
swer the purpose. Children are often relieved by covering them with 
a hot flannel, laying them upon the belly on the knee, and trotting 
them, at the same time tapping them gently upon the back. This 
should be done cautiously ; for if unsuccessful, it might increase the 
suffering ; and the infant has no language but screams to tell its dis- 
tress. 

Falling of the Bowel. — Prolapsis Ani. 

In cases of long-continued looseness, the lower bowel of children 
sometimes gets so weakened, that it drops down, and projects through 
the fundament. Occasionally, only the mucous membrane which 
lines it comes down, in the shape of a small tumor, causing a sense 
of bearing down and smarting. These fallings-down occur when the 
child goes to stool. Whether it be the bowel or the lining membrane 
which has come down, if it be allowed to remain long down, inflam- 
mation will take place, and to return it will then be very difficult 

Treatment. — Place the child upon his back, and, having smeared 
the thumbs, or fore fingers, with lard or sweet oil, press them gently 
upon the tumor in such direction as shall tend to return it within the 
body. If this does not succeed, push the forefinger into the gut, so 
as to relax the circular muscle which contracts upon and holds it. If 
the falling is caused by straining at stool, made necessary by costive- 



404 CARE OF CHILDREN AXD THEIR DISEASES. 

ness, some ripe fruit stewed in molasses, or rye hasty-pudding and 
molasses, should be given to the child daily, and it should be caused 
to empty the bowels while standing up. To strengthen the bowel, 
few things are better than cold water, applied to the fundament sev- 
eral times a day. An astringent wash of oak bark (232), is also val- 
uable. Should the bowel become so much relaxed that these means 
fail, a tight bandage must be applied to support the fundament. Be 
careful that some ignorant pretender does not, — as has happened, — 
apply the ligature or the knife, and cut off the tumor, instead of re- 
turning it into the body. 

Gastric Fever of Infancy. 

The inflammatory affections of the bowels, which happen after 
teeth-cutting, are frequently accompanied by remittent fever, — the 
fever showing itself very distinctly towards evening, and subsiding, or 
nearly disappearing, in the morning. It is a sympathetic fever, and 
is generally the result of a reaction produced by inflammation of the 
stomach, or ileum, or colon. The attack is sometimes sudden, though 
generally gradual. 

Symptoms. — For several days, the child will be languid and fretful, 
with loss of appetite, increased thirst, and some heat of skin. Tow- 
ards night these symptoms are more intense ; the skin is more hot, 
the thirst and restlessness are greater, the pulse more rapid. In the 
m-orning, the skin is more moist and cool, and the child falls into a 
short, disturbed sleep. Early in the attack, the bowels are consti- 
pated, — though there is sometimes diarrhoea, or a frequent desire to 
go to stool without much being passed. The evacuations are always 
unnatural and very offensive. They are dark-colored, or clay-like, or 
of the consistency of tar, — sometimes mixed with mucus, and occa- 
sionally with blood. There is tenderness of the belly, and pressure 
upon it causes pain. It is also hot to the touch, while the feet are 
cold. The face is flushed, and the breath has a decidedly sickly 
smell. The stomach is irritable, and vomiting is frequent. The 
tongue, after a time, becomes coated, dry, and pointed. 

In the chronic form of the disease, there is, frequently, diarrhoea, 
the passages being unhealthy and fetid ; the tongue is covered with a 
brownish-yellow mucus, the teeth with sordes ; the lips are parched 
and cracked ; the urine is scanty and high-colored, with a white sedi- 
ment ; the skin, dry, harsh, and dirty-looking ; the countenance con- 
tracted and wrinkled ; and there is, frequently, a dry, hacking cough. 

Treatment. — Regulate the diet. This is important. In recent and 
acute cases, withhold all food, except some cold mucilaginous fluid 
as drink, as rice-water, gum-water, infusion of slippery-elm bark, or 
milk diluted with barley water. Give a warm or tepid bath daily. 
Purgatives should be used sparingly. The bowels, when costive, had 
better, generally, be opened by injections of tepid water, or thin gruel. 
If any laxative be used, let it be the compound rhubarb powder, or 



CAKE OF CHILDREN AND THETR DISEASES. 405 

either of the following, (28) (281). When the discharges have 
become healthy, and the tongue clean and moist, some light bitter, 
as the infusion of Peruvian bark, or Colombo, in combination with 
diluted sulphuric or hydrochloric acid, may be given. These, care- 
fully given, with the daily tepid bath, and exercise in the open air, 
will soon restore the strength. 

Mesenteric Disease. 

This attacks scrofulous children between the ages of three and ten 
years. Its symptoms are a prominent belly and loss of flesh, — par- 
ticularly upon the arms and legs. To be able to feel the enlarged 
ajid hardened glands, through the walls of the belly, is the surest sign 
of this disease. When the complaint is long-continued, the child 
loses all its flesh, and dies in almost a complete skeleton state. 

Treatment. — If there is inflammation or other disorder in the 
stomach or bowels, attend to this first Then put the patient on a 
generous diet, such as meat broths, etc. Give bicarbonate of potassa, 
dissolved in the infusion of columbo or quassia, and when there is 
costiveness, add rhubarb to the preparation. For the enlargement of 
the glands, apply, externally, an ointment (184) of the iodide of lead, 
or of the iodide of potassium (185). Give an ioduretted bath, daily, 
w^iich is formed by adding one grain of iodine and two grains of 
iodide of potassium to each gallon of warm water. 

The syrup of iodide of iron should be given, internally, three times 
a day, in a little water, or the iodide of potassium, and compound 
infusion of gentian. Daily sponging the body in salt and water, and 
exercise in the open air, are important. 

Rickets. 

This is also a disease of scrofulous children. By some bad process 
of nutrition in such children, there does not enough phosphate of lime 
enter into the bones to harden them, and the weight of the body, or 
the pulling of the muscles, or the pressure of the clothing, bends and 
distorts them in all manner of ways. The heads of the thigh bones 
are pushed nearer together, making the lower belly narrow ; the back 
bone is so curved as to lessen the height ; the shoulder blades stand 
up like wings when flying is contemplated ; and the shoulders are so 
lifted up that the head seems only a little higher than the elevations 
on each side. 

Treatment. — A good, generous, wholesome diet, properly regulated; 
out door exercise ; the tepid or cold salt water sponge bath, with fric- 
tion, and but little medicine. The hypo-phosphite of lime, in two- 
grain doses, given in a little sweetened water, three times a day, or the 
syrup of the hypo-phosphites, in half-teaspoonful doses, three times a 
day, may be given with advantage. 



406 CARE OF CHILDREN AND THEIR DISEASES. 



The Blue Disease. — Cyanosis. 

This disease is known by a blue, purple, or leaden tinge over the 
whole body. The warmth of the body is reduced, there is difficult 
breathing, which is increased by quick motion or by crying. The 
disease is generally fatal. The blueness is occasioned, either by the 
passage between the right and left side of the heart remaining open 
after birth, so as to let the blue, venous blood run through and mix 
with the red arterial blood, thus making the whole blue, or by the 
obstruction of the pulmonary artery, which withholds the blood from 
the lungs, and does not allow it to be arterialized and reddened. 
This latter opinion is the more general one now. 

Treatment. — Keep the patient, as much as possible, in a state of 
rest, so that the circulation may not be hurried. Allow a pure fresh 
air, easily-digested food, and protect the body from cold and damp- 
ness. Hold the infant near the fire, and apply gentle friction over the 
head and body with a warm, soft cloth. 

Tits. 

Most persons have seen a baby in fits ; and it is a sad sight, — its 
little face all distorted and livid ; its eyes rolling and squinting fright- 
fully; its hands clenched, and arms bent, and legs drawn up, and body 
arched backward, and limbs twitching violently, ^ — itself insensible, 
and unable to see, or swallow, or move. After a time, the fit ceases, 
sometimes by degrees, at other times suddenly, — the child fetching a 
deep sigh, and then lying quiet and pale, as if it had fainted. From 
this state it passes into a sleep, and, on "waking, some hours after, 
seems quite well. 

Fits may attack a child which is apparently well, and kill it im- 
mediately, or it may have fits daily, or even several times a day, 
and linger on for weeks. A child may have fits from a great vari- 
ety of causes. Fits, therefore, have a different meaning in different 
cases. But they always show that the brain has in some way been 
disturbed. 

Treatment, — As fits are not a disease in themselves, but only a 
symptom of some disease, the treatment must have reference to the 
cause. Sometimes, while the fit lasts, it is wise to do nothing. But, 
if a fit come suddenly, in the case of a child previously healthy, it is 
generally safe to place it in a hot bath, and at the same time, to dash 
cold water -on its face, or to pour cold water on its head, or hold on 
it a large sponge dipped in cold water. The hot bath will draw the 
blood to the skin, and away from the over-loaded brain. It will quiet 
the disturbance of the system, and if scarlet fever or measles are 
about to appear, it will bring them out. 



DISEASES OF THE GENERAL SYSTEM, 



Having now treated of those disorders which affect the skin, the 
brain and nerves, the throat, the lungs and their appendages, the heart 
and its covering, the abdominal cavity and its lining membrane, the 
sexuai organs, and those complaints peculiar to females and children, 
it remains to speak of those others, — fewer in number, — which are 
not specially developed in any particular part, but disturb the whole 
system. 

Fever. 

Fever is a disease which affects the system generally, and is char- 
acterized by more or less excitement of the circulation, increased heat, 
diminished strength, and, oftentimes, unnatural thirst. The degree 
of excitement is measured by the state of the pulse. Of this state, 
there are two characteristic indications : n^xneXy, frequency and hard- 
ness. A pulse is frequent when its rapidity exceeds that of health ; 
it is hard when its stroke resists the pressure of the finger with 
unusual force. 

In health, the pulse of an adult beats from sixty to eighty times in 
a minute ; that of children is more frequent. The pulsations of the 
heart of the unborn infant, as heard through the body of the mother, 
are one hundred and fifty in a minute. After birth, the pulse varies 
from one hundred and forty down to the standard of adult age. To 
appreciate hardness of pulse, experience is absolutely necessary. 

The great activity of the circulation, in fever, is intimately con- 
nected with the heat and thirst, and tends directly to waste the ener- 
gies, and consume the strength of the patient. The heat of fever 
lessens or dries up the secretions, or different fluids of the body, 
which, in a state of health, are separated from the blood for various 
purposes. This is the cause of the dry skin, scanty urine, etc. 

A crisis of fever is that period in its course when unfavorable symp- 
toms give place to those of returning health. 

A course of fever ^ or, in common language, a run of fever, is dis- 
tinguished by a great variety of symptoms, which will be more par- 
ticularly spoken of in the pages which follow. 



408 DISEASES OF THE GENERAL SYSTEM. 



Typhoid Fever. 

Of the different kinds of fever, this is one of the most common and 
widely prevalent. The name typhoid is from two Greek words which 
mean like typhus, or similar to typhus. The word typhus, from a Greek 
word signifying stupor, means stupid, dull, or low ; and, when applied 
to a fever, implies that it is low, or characterized by great nervous 
depression. 

Typhus and typhoid fevers, if not identical, are so similar in history 
and treatment as to make unnecessary their consideration under sep- 
arate heads. The following is one of the differences claimed to exist 
between the two : namely, in typhus fever, the belly is flat ; there is 
no marked disease of the bowels, and generally no diarrhoea until the 
second or third week. In typhoid fever, on the contrary, some small 
glands, called Peyer^s glands, situated in the lower part of the small 
intestines, are always inflamed, and sometimes ulcerated ; and, con- 
sequently, among the symptoms most frequently noticed, are diar- 
rhoea, and drum-like swelling of the belly, called tympanites. 

Symptoms. — The disease often has precursory symptoms. For 
several days before its actual beginning, the patient droops. He may 
attend to his various duties, but does not seem well; he is low-spirited 
and languid ; is indisposed to any exertion of body or mind ; has 
pains in the head, back, and extremities ; loses his appetite ; and 
although dull and perhaps drowsy in the day time, his sleep is inter- 
rupted and unrefreshing at night. The immediate harbinger of the 
fever is a chill, often so marked as to cause violent shivering. 

The history of the first week shows increased heat of the surface ; 
frequent pulse, ranging from eighty to one hundred and twenty; 
furred tongue ; restlessness and sleeplessness ; headache and pain in 
the back ; sometimes diarrhoea and swelling of the belly ; and some- 
times nausea and vomiting. 

The second week is frequently distinguished by an eruption of 
small, rose-colored spots upon the belly, and by a crop of little watery 
pimples upon the neck and chest, having the appearance of minute 
drops of sweat standing on the skin, and hence called sudamina, or 
sweat drops ; the tongue is dry and black, or red and sore ; the teeth 
are foul ; there may be delirium and dulness of hearing ; and the 
symptoms generally are more serious than during the first week. 
Occasionally, at this period, the bowels are perforated or ate through 
by ulceration, and the patient suddenly sinks. 

If the disease proceeds unfavorably into the third week, there is 
low muttering and delirium ; great exhaustion ; sliding down of the 
patient towards the foot of the bed ; twitching of the muscles ; bleed- 
ing from the bowels ; and red or purple spots upon the skin. 

If, on the other hand, recovery takes place, the countenance bright- 
ens ; the pulse moderates ; the tongue cleans, and the discharges 
assume the appearance they have in health. 

Treatment. — Give the patient good air, and frequent spongmgs 



DISEASES OF THE GENERAL SYSTEM. 409 



with water, cold or tepid, as shall be most agreeable to his feelings. 
Keep the bowels in order ; by which is meant, be more afraid of 
diarrhoea than of costiveness. Diarrhoea should be restrained by a 
little brandy, or by small and repeated doses of Dover's powder (153). 

For costiveness, give injections, or the mildest aperients (7) (10) (12). 

To lessen the frequency of the pulse, reduce the fever, and pro- 
duce perspiration, give from three to ten-drop doses of the tincture or 
fluid extract of veratrum viride, every hour. This remedy has great 
power in fever. 

Great wind-swelling of the bowels may be relieved by fomenta- 
tions, or hot, steaming applications. Sometimes the wind may be 
let off by introducing into the bowels a long gutta percha tube, — 
thus reducing the swelling, and greatly promoting the patient's com- 
fort. 

If pain in the head be severe and constant, let the hair be cut short, 
and the head be frequently bathed witli cold water. 

Let the strength be supported by light nourishment ; and in case 
of bleeding from the bowels, or great debility, by broth and wine. 

For foul mouth, the weakest possible infusion of old hyson tea is 
valuable. Good nursing is eminently desirable. 

If the fever runs a low course, the patient being much prostrated, 
quinine, even in large doses, may be given from the beginning. 

Bilious Remittent Fever. 

There are three principal varieties of periodical fever, which^ though 
varying considerably from each other, in several particulars, are yet 
essentially, in their substance, but one disease. These are Bilious 
Remittent Fever, Pernicious Intermittent or Congestive Fever, and 
letermittent Fever or Fever and Ague. According to the custom of 
most writers, I shall treat them separately, beginning with Bilious 
Remittent Fever. 

Sjinptoms. — The attack is generally sudden and well marked. 
Some writers say it has no premonitory symptoms ; others, that it 
has. The more general understanding is, that for a day or two, or 
even longer, before the onset, there is a sense of languor'and debility, 
slight headache, lack of appetite, furred tongue, bitter taste in the 
mouth in the morning, pains in the joints, and general uneasiness. 

The formal onset is nearly always marked by a distinct chill, or rigor, 
— sometimes slight and brief; at other times severe and prolonged. 
The chill may begin at the feet, or about the shoulder blades, or in 
the back, and thence run like small streams of cold water poured in 
every direction through the whole body. There is generally but one 
well-marked chill, the returns of the paroxysms of fever being seldom, 
after the first, preceded by the cold stage. 

At certain periods of the day, there is an increased intensity in the 
symptoms of the disease, occasionally preceded, though generally not, 
by the chill. Between this period of severity in the feverish symp- 
toms, and a similar period which follows it, there is generally decrease 

52 



410 DISEASES OF THE GENERAL SYSTEM. 

in the violence of the symptoms, during which the fever moderates, 
but does not, as in fever and ague, entirely go off; has distinct remis- 
sions^ but not complete intermissions. 

During the hot stage, the pulse is up to one hundred and twent}^, or 
one hundred and thirty. There are pains in the head, back, and limbs, 
of a most distressing kind. 

The tongue is generally covered with a yellowish, or a dirty-white 
fur ; and in bad cases, in the advanced stage, is frequently parched, 
brown, or nearly black in the centre, and red at the edges. There is 
no appetite for food, and generally nausea and vomiting ; and usu- 
ally there is pain and tenderness in the epigastrium. The bowels are 
at first costive, but afterwards become loose, and there are frequent 
evacuations of dark, offensive matter. 

Causes. — This disease is produced by malarial exhalations from 
the decomposition of vegetable matter. It is most prevalent in hot 
climates, and in the summer and autumn. 

Treatment. — K the fever be in the formative stage, and have not 
fully developed itself, give an emetic (1) (2), and follow it with a mild 
cathartic (7) (13). 

If the disease be already developed, sponge the body, all over, sev- 
eral times a day, with cold or tepid water, according to the feelings 
of the patient, and give cooling drinks (132) (133) (298) (299). to 
moderate the fever, give three to ten-drop doses of tincture, or fluid 
extract of veratrum viride. The compound powder of ipecac and 
opium is a valuable preparation for the same purpose. Give cold 
water as drink if desired by the patient, or let him eat ice. 

When the headache is very severe, let wet cups be applied upon the 
temples, or behind the ears ; and the same remedy to the pit of the 
stomach, when there is great tenderness, is often desirable ; though a 
mustard poultice will sometimes do better. 

During the remissions of the fever, quinine, and other tonics are to 
be given, as in fever and ague. 

Congfestive Fever.— Pernicious Intermittent Fever. 

This is the pernicious, or malignant form of malarious fever. It is 
marked, either in the earlier or later stage, by a rush of blood towards 
one or more organs, by which they are crowded full and congested^ — 
hence its title of congestive fever. 

Symptoms. — It may be intermittent^ or remittent^ — more com- 
monly, it is the former. It may assume any of the types of peri- 
odical fever, but it is most frequently quotidian or tertian. 

The first attack does not differ very materially from a common 
attack of simple intermittent. The first paroxysm is simple, exciting 
but little attention. The second is always severe, producing great 
coldness, and a death-like hue of the face and extremities. The 
advancement of the disease brings dry, husky, parched, and pun- 
gently hot skin, followed, after a time, by a cold, clammy sensation. 



DISEASES OF THE GENERAL SYSTEM. 411 

The eyes are dull, watery, and sometimes glassy; the countenance 
dull, sleepy, distressed ; the tongue, at first white, changes to brown 
or black, a^id is usually tremulous ; the breathing is hurried and diffi- 
cult Pressure over the liver, stomach, or bowels, produces pain. 
The mind is often disturbed, and falls into lethargy and stupor, or is 
delirious. 

Treatment. — This should be very much like the treatment of the 
bilious remittent fever. 

While getting up from the fever, the diet must be light and nutri- 
tious at first, but may be increased in quantity as the strength returns. 
Exercise out of doors must not be omitted. If recovery be slow, 
some mild tonic, or a little wine, or ale, or brandy, may be taken two 
or three times a day. 

Fever and Ague.— Intermittent Fever. 

This is a kind of fever in which there is a succession of attacks 
with equal intervals^ and intermissions that are complete but unequal, 
on account of the uncertain duration of each fit. 

An interval is the period of time between the beginning of one fit, 
and the beginning of the next. 

An intermission is the period of time between the close of one fit, 
and the beginning of the next. 

The dift'erent varieties of ague take their designation from the 
length of the interval in each case. 

The interval of a quotidian^ or dail^ ague, is twenty-four hours. 

The interval of a tertian, or third-day ague, is forty-eight hours. 

The interval of a quartan, or fourth-day ague, is seventy-two hours. 

Symptoms, — The disease first develops itself by an ague fit. This 
has three stages, the cold, the hot, and the sweating. The cold 
stage is very marked. The patient has a sense of a debility, yawns, 
stretches, has no appetite, and does not wish to move. The face and 
extremities become pale, the skin shrinks, causing universal horripila- 
tion, ox goose-flesh ; the patient shakes, and his teeth chatter. 

After a time, these symptoms decline, and the hot stage comes on, 
which is characterized by high fever, with its various uncomfortable 
sensations. 

When this fever passes ofi", it is followed by the sweating stage, 
during which a moisture breaks out which increases, frequently, to a 
profuse sweat ; the body returns to its natural temperature, the pains 
and aches disappear, and a feeling of health comes back. 

During the cold stage, the blood is driven inward from the surface, 
and particularly oppresses the spleen, which, in cases of long standing, 
becomes swelled and permanently enlarged. This swelling may be 
plainly felt, and is often quite perceptible to the eye. It is called 
ague cake. 

Ague fits begin at different hours of the day, and generally termi- 
nate in the evening. 



412 DISEASES OF THE GENERAL SYSTEM. 

A quotidian usually begins in the morning; a tertian at noon; and 
a quartan in the afternoon. 

The cold stage is shortest in the quotidian, and longest in the 
quartan. 

Thus the longest fit has the shortest interval, and the shortest cold 
stage ; while the shortest fit has the longest interval, and the longest 
cold stage. 

There are also double tertians and double quartans, wherein the 
fits repeat themselves, — sometimes the same day, at other times on 
alternate days. 

To these varieties, the terms postponing and anticipating are ap- 
plied, according as the intervals are growing longer or shorter. When 
a person is recovering from ague, the interval may gradually grow 
longer, the attack being put off^ or postponed. But if the disease be 
increasing in severity, the attack may anticipate its usual period, mak- 
ing the interval shorter. 

Tertians are more common than either quotidians or quartans. 

Agues are more prevalent in spring and autumn. Fall agues are 
most severe and dangerous. 

Causes. — Exhalations from the soil, called malaria^ arising from 
decomposition of vegetable matter in new countries, or from low and 
marshy districts in which the land is alternately covered with water, 
and again left dry and exposed to the sun. 

In districts where it prevails, high hills are exempt, and even the 
upper stories of houses are more healthy than the lower. 

Treatment, — First clear the bowels with the fluid extract of senna 
(15), or the preparation (21). Then, in the cold stage, give hot, and 
in some cases, stimulating drinks. Administer hot foot baths, and, 
putting the patient in bed, apply bottles filled with hot water to the 
feet, sides, and back, and in every way try to excite warmth and 
comfort. 

In the hot stage, give cooling drinks, and opium (117) (118) in de- 
cided doses ; or, what is better, quinine (67) in two teaspoonful doses 
every half hour, at the same time giving five-drop doses of tincture or 
fluid extract of veratrum viride every hour. 

'During the sweating stage, stop the veratrum, and rub the patient 
with dry towels. 

In the intermission, give quinine (62), in three-grain doses, once in 
three or four hours, and continue it, gradually increasing the dose, a 
fortnight after the cessation of the attacks. The following is a good 
preparation : quinine, one scruple ; elixir of vitriol, one dram ; dis- 
solve the quinine in the elixir, and add tincture of black cohosh, four- 
teen drams. Twenty drops are to be given, in a little water, once an 
hour. 

The web of the black spider, rolled up into five-grain pills, and 
taken, one pill at a time, once in two hours during the intermission, 
is said to cure many cases. 

It is important, in fever and ague districts, to avoid the hot sun, 
and the damp evening and morning air. 



DISEASES OF THE GENERAL SYSTEM. 413 



Yellow Fever. 

This disease belongs to warm climates, being most prevalent in 
Southern cities. It makes its appearance chiefly in the latter part of 
summer, and disappears upon the approach of frosty weather. 

Smiptoms. — The complaint begins, generally, with a chill, which 
is sometimes severe, though commonly moderate, of short duration, 
and rarely repeated. 

Following this chill, there is moderate fever, and a little heat of 
surface ; but this rarely rises to any considerable height, and only 
continues to the second or third day, when, in fatal cases, it gives 
place to coldness of surface, etc. In many cases there is sweating. 

The pulse is peculiar, — not easily described, — generally not rising 
above one hundred in a minute, — a kind of bubble under the finger, 
which breaks and vanishes before it can be fairly felt. 

The tongue is moist and white in the first and second days, but 
red, smooth, shining,* and dry, as the disease advances towards the 
close, having a dry, black streak in the middle. 

The most striking symptoms are nausea and vomiting. The vom- 
iting, in fatal cases, is generally very persistent, and towards the ter- 
mination, the yellowish or greenish matters thrown give place to thin 
and black fluid, having a sediment looking like coffee-grounds. This 
is called the black vomit. 

The bowels are generally costive, with frequent epigastric tender- 
ness and distress. There is generally severe headache, and a pecu- 
liar expression of countenance, in which the lips smile, but the rest 
of the face is fixed and sad, sometimes wild. The patient continues 
wakeful, nrght and day. There are discharges of blood, often, from 
the nose, the gums, the ears, the stomach, the bowels, and the urinary 
passages. 

Treatment. — First, move the bowels with some mild physic (40) 
(18) (19) (41) (37). 

During the chill, put the feet in a mustard bath (242), give warm 
cordial drinks, and apply hot bottles etc., externally. 

Cups may be applied to the back of the neck, or over the stomach, 
according to circumstances. 

During the second stage, or stage of calm, nothing is to be done 
but give some light stimulants, and to promote sweating by warm 
drinks, and tincture of veratrum viride ; and also quinine (62). 

The third and severest stage is to be met by stimulants, as brandy, 
freely given, with a continuance of the quinine. 

During the fever stage, and for the vomiting, give creosote, twenty 
drops to six ounces of spirits of Mindererus, and alcohol enough to 
dissolve the creosote. The dose is half an ounce every two hours. 
Said to be excellent for putting a stop to the retching and vomiting. 

Cleanliness, temperance, and cheerfulness, are essential in warding 
off* the disease when one is exposed to its cause. 



414 DISEASES OF THE GENERAL SYSTEM. 



Rheumatism. 

This is an inflammation of a peculiar character, being caused by 
acid or poisonous matter in the blood, and having for its seat the 
fibrous tissue^ or that thready texture which enters largely into the 
composition of the cords and muscles of the human body. The 
synovial, or lining membrane of joints, is also peculiarly subject 
to rheumatic inflammation. Hence the terms, fibrous rheumatism, 
and synovial rheumatism. There are also acute and chronic rheu- 
matism. 

Acute Rheumatism 

Is a very painful affection. It is most frequently brought on by 
exposure to wet and cold after violent and fatiguing exercise of the 
muscles. 

SjTiiptoms. — Its principal characteristics are, high fever, with a 
full, bounding pulse ; furred tongue ; profuse sweat, which has a sour 
smell, and seems to increase the weakness without relieving the 
pain ; scanty and high-colored urine, with brick-dust settlings ; and 
swelling of the joints, with slight redness, great tenderness, and severe 
pain, which is particularly agonizing when the patient attempts to 
move. 

This affection often changes suddenly from one part of the body to 
another, or from one set of joints to another. This sudden shifting, 
termed metastasis, is peculiarly dangerous ; for sometimes the inflam- 
mation, seeming to regard the constantly moving heart as a large 
central point, suddenly seizes upon its lining membrane, and occasion- 
ally proves speedily fatal. 

Treatment, — It is well first to open the bowels freely with the 
compound powder of leptandrin, or the compound powder jalap. 
Then give tincture of black cohosh and tincture of veratrum viride 
(124), and push the preparation to the extent of producing sweating. 
This, if no evil effects seem to result from it, that is, no prostration or 
bad feelings in the head, may be kept up till the violence of the dis- 
ease abates. 

Sometimes opium, nitrate of potash, etc. (127), administered one 
or more times, will have a good effect. 

The tincture of black cohosh root, two parts, and the tincture of 
colchicum root, one part, and given in doses of forty drops, is a valu- 
able remedy. 

For articular rheumatism, iodide of potassium, one dram, and 
morphia, one grain, dissolved in one ounce of water, and given three 
or four times a day, in two teaspoonful doses, are said to have the 
power of shortening the disease. 

It is a valuable treatment, after clearing the bowels \^dth salts and 
senna, to give equal parts of wine of colchicum and spirits of tur- 



DISEASES OF THE GEXEKAL SYSTEM. 415 

peiitine in doses of ten drops every two or three hours ; and after a 
day or two, to give, in connection with the above, at intervals of five 
hours, tincture of chloride of iron, ten drops, with ten to twenty drops 
of laudanum. 

Fomentations of hops and cicuta, or stramonium leaves, placed 
upon the inflamed and swollen joints, will have a good effect in 
relieving the pain. The recent leaves of stramonium, pounded, mixed 
with a little water, and laid upon the joints, is said to act very 
favorably. 

Chronic Rheumatism. 

The chronic form of rheumatism may follow the acute as its conse- 
quence, but is more often an independent disease. It is seldom at- 
tended by fever, and in this differs from the acute rheumatism. It 
often lasts a long time, and causes much suffering. 

Sjinptoms. — These are various, but are generally understood, even 

by the common people, to consist of pain, lameness, stiflfness, etc., in 
the joints and other parts. The joints are often swollen, but not as 
much as in the acute disease. It is peculiar to this form of the com- 
plaint, that when the patient remains at rest for a time, he will have 
pain and stiffness in the affected part on beginning to move, but as 
he grows warm, both w^ill disappear. 

Treatment. — This complaint is often palliated, and sometimes 
cured, by passing a current of electro-magnetism through the affected 
part. 

The tincture or the fluid extract of black cohosh, taken in full 
doses, is one of the best remedies. It may be taken alone, or mixed 
with the tincture of poke-berries, and a tincture of prickly-ash bark, 
if convenient. 

Opium and nitre (127) form a valuable remedy. Colchicum is 
much used, and has a deservedly high reputation (292) (301). 

Liniments often have a good effect (190) (195) (196) (198). It is 
well to wear a piece of oiled silk over the affected part. It keeps up 
a gentle perspiration from the rheumatic surface, and materially 
hastens a cure. 

To bathe the affected joint at bed-time with hot sweet oil, and then 
envelop it in cotton batting, to be kept on through the night, will 
often give much relief. 

The bowels must be kept regular, and all exposure to wet feet or 
clothes, and to currents of cool air when sweating, must be carefully 
shunned. 

Gout. 

Gout is rheumatism's cousin ; the parentage of both belong to the 
brotherhood of the acids. 

A very acid state of the blood, or a state favorable to the forma- 
tion of acid, is supposed to be the cause of the inflammation peculiar 



416 DISEASES OF THE GENERAL SYSTEM." 

to both these disorders. In rheumatism, an acid which exists in sour 
milk, and in cider, called lactic acid, is thought to be the disturbing 
element. In gout, lithic or uric acid is known to be uncommonly 
abundant, and to form a principal ingredient of those concretions, 
found in gouty joints, and familiarly called chalk-stones. 

The larger joints are most often affected by rheumatism ; while 
gout prefers the smaller ones. In rheumatism, the pain is excruciat- 
ing ; in gout, it is intolerable. There is truth in the humorous 
Frenchman's description of the pains of these two complaints, which 
is, in substance, as follows : Place your joint in a vice ; turn the 
screw till you can bear it no longer ; that gives you an idea of rheu- 
matism ; now give the instrument one more turn, and you have 
gout 

Symptoms. — A fit of the gout, as it is called, generally makes its 
attack in the night. Its unsuspecting victim is first awakened, per- 
haps an hour or two after midnight, by an intensely burning, wrench- 
ing pain in the ball of the great toe, or some other small joint. This 
pain, with its accompanying symptoms of fever, continues with little 
abatement for twenty-four hours. There is then a distinct remission, 
when the sufferer may get some sleep. He has a similar experience 
during several succeeding days and nights, when the disease, which 
has been growing milder, leaves him. 

After a considerable interval, there is likely to be another similar 
visitation. The length of this interval is inversely as the number of 
attacks, — that is, it diminishes in length as the attacks increase in 
number ; in yet plainer and more homely terms, the attacks come 
" thicker and faster ; " the space between them gradually shrinking 
from three or four years to one or two months. 

Recovery from the first attack may be complete, — the skin peeling 
off from the red and swollen joint, and leaving it strong and supple 
as ever. But, after several repetitions of the inflammation, the joint 
becomes stiff, its motions being obstructed by the deposit of lithic 
acid concretions, or chalk-stones. The limbs are fig. 143. 

sometimes actually frosted over with crystals of 
urate of soda (Fig. 143). This form of urate of 
soda crystals differs very materially from Fig. 122. 
When these crystals appear upon the surface, and 
deposits are made in the joints, uric acid is not 
secreted as usual by the kidneys, but accumulates 
in the blood. 

But gout is a disease by no means entirely local 
in its character. It vitiates the blood, affects the system generally, 
and is often betrayed by general symptoms long before the local mis- 
chief is indicated by one of the attacks. Irritability of temper, un- 
pleasant sensations in the stomach and head, and various uncomfort- 
able feelings of body and mind, have been considered as premonitory 
of this disorder. Many other organs also, beside joints, are subject to 
the gouty inflammation. The stomach, heart, lungs, head, and even 
the eyes, are known to have been thus affected. 




DISEASES OF THE GENERAL SYSTEM. 417 

Causes. — Luxury and indolence, — particularly the former, — are 
regarded as the principal causes of gout. 

Treatiuent. — Colchicum is the remedy for gout. It removes the 
disease by exciting the kidneys to action, so that the poison is con- 
veyed away in the urine. Perhaps it acts in some other unexplained 
way, as an antidote to the disease. One teaspoonful of the wine of 
colchicum may be taken two or three times a day, until relief is ex- 
perienced. It should then be continued, in ten-drop doses, for a few 
days longer, to prevent a relapse. The colchicum may be taken in 
the form of prescription (301). 

Coffee, drank freely every day, is said to be a sovereign remedy 
for gout. It is also declared to be excellent for gravel, — a fact 
which I forgot to mention when treating of the affections of the 
kidneys, etc. 

The bowels must be kept in order, but not actually purged (34) 
(40). The diet must be simple and unstimulating. 

Let the inflamed joint be bathed often in a saturated solution of 
bicarbonate of soda in soft, warm water. Cold applications should 
not be made, as there is danger of provoking a sudden change of the 
inflammation to some internal organ. 

Scrofula.— King's Evil. 

This disease was once thought to be peculiar to swine, and hence 
derived its name from scrofu^ a sow. It shows itself in various forms, 

— as hip disease, white swelling, rickets, salt-rheum, etc. Persons 
affected by it are subject to swelling of the glands, particularly those 
of the neck. 

Symptoms. — In the beginning of the disease, small, hard, movable 
kernels appear about the neck, just under the skin. These are lym- 
phatic glands, and the swelling generally takes place long before there 
is any soreness, or perceptible redness. They may be felt under the 
skin ; and, in the course of six months or a year, may grow to the 
size of a filbert, or even a hen's egg. Sometimes they are much 
larger even than this, and very hard. They may appear in many 
other parts beside the neck. 

After a time, though very slowly, they come to a head, and break, 

— discharging a watery fluid, or a mixture like whey and curd. They 
are seldom very sore. When they heal, they are apt to leave a puck- 
ered condition of the skin, and ugly scars. 

The scrofulous humor may sometimes affect the eyes, when the 
lids will become red and thick, and discharge mucus and water ; — 
the under lid sometimes turning out, and presenting a shocking 
spectacle. 

The scrofulous condition is generally supposed to be indicated by 
a white, delicate skin, thick lips, light hair, and a delicate constitu- 
tion ; but these signs are not worthy of much confidence. 

The disease often attacks the cellular tissue, causing numerous 

53 



418 DISEASES OF THE GENERAL SYSTEM. 

suppurations and abscesses. It also affects the bones, producing 
caries, necrosis, and other affections. It shows itself in certain in- 
flammations of the eyes, in the formation of running sores in the 
ears, and in various other ways. 

Causes. — It is contended by some, that scrofula is in all cases 
inherited ; that we receive it from our progenitors, as we do their 
other constitutional peculiarities ; that the disease is everywhere, and 
in all time, one and the same, which shows it to come from within, 
and not froA without ; that were it dependent on external causes for 
its existence, it would be greatly modified by temperature, climate, 
and the peculiarities of the races affected by it. 

They assert that though the causes which are usually assigned 
for scrofula, such as living in cold, damp, and impure air, and the 
lack of sufficient food, connected with filthy habits, often have a 
powerful effect in developing scrofula already existing in the con- 
stitution, and of aggravating it when already developed ; it never 
produces it. 

How far these statements are to be received, I will not undertake 
to judge. It is certain that the disease is often inherited ; and if we 
admit that the other causes named have some share in its production, 
it is possible we may not go entirely astray. Yet my own strong 
suspicion that scrofula arises from the animal poison of syphilis, fil- 
tered through the blood of many generations, inclines me to the adop- 
tion of the above views. 

Treatment. — In olden times of superstition, this disease was be- 
lieved to be cured by the patient coming into the presence of the 
king, and being touched by his royal hand. The ceremony was 
called the "sacred touch." It was from this that the disease took 
its name of "king's evil." This superstition reached its height in 
the reign of Charles II. After the Restoration, the numbers who 
flocked to Whitehall and Windsor to receive the " touch," are said to 
have been immense, — no less than ninety-two thousand in twelve 
years ; and the writers of that day declare that none failed to receive 
benefit. 

In modern times, believing that tbe ceremony of the touch was 
best adapted to the period when kings were thought to have sacred 
persons, we rely for the cure of this disease, upon rational medicine 
and hygiene. 

The medical treatment of it is constitutional and local. 

Iodine is the great remedy for scrofula. Dissolve one scruple of 
iodine and two scruples of iodide of potassium in seven teaspoonfuls 
of water. Of this, give ten drops three times a day, in a little 
water, gradually increasing the dose to once and a half or twice 
that amount. The iodide of potassium, as in prescription (101), is a 
good remedy. 

Where there is considerable debility, the iodide of iron, in doses 
of twenty -five or thirty drops, in water, three times a day, is a good 
preparation. 



DISEASES OF THE ge^t:ral syste:m. 419 

The compound syrup of yellow dock root, and the compound 
syrup of stillingia, taken sometimes alone, and at other times, with 
two to five grains of iodide of potassium in each dose, are both ex- 
cellent medicines for scrofula. 

The bowels must be kept open by laxative food, or in the failure 
of this, by some gentle physic (12). 

Medicinal springs, particularly those containing iodine, are ex- 
cellent. 

Before the tumors become very sore, let them be bathed several 
times a day with a solution of muriate of lime, or ammonia, or soda, 
two drams to the ounce of water. When they are inflamed, apply 
poultices of ground slippery elm and powdered bayberry, equal parts. 
Powdered poke-root, or blue-flag may be substituted for the bayberry. 
If these things are not at hand, use white bread and milk, or flax-seed 
poultices. 

When the tumors have opened, and ulcers have formed, the ulcers 
must be washed out with soap suds, and dressed with salve made of 
beeswax and sweet oil ; or, when the ulcers are indolent, with the 
red iodide of mercury ointment. Let the dressing be changed two 
or three times a day. 

Great attention should be paid to the improvement of the general 
health. The diet must be ample and nourishing, — consisting of fresh 
meat, poultry, broths, soups, milk, and wholesome vegetables in such 
variety as the season allows. 

The skin must be washed daily with cool water and spirit, or water 
and saleratus ; and Tubbed to redness with a coarse towel, or flesh 
brush. Either flannel or silk should be worn next the skin, summer 
and winter. 

Exercise must be regular, and cheerfully performed, in the open air. 
If the residence be in a damp and unhealthy air, it should be changed 
at once, if possible. In any case, a change of residence, from time to 
time, when travelling is not possible, is much to be desired. 

Scurvy. — Scorbutus, 

Owing to a better knowledge of this disease, and of its proper 
treatment, it is much less common than in former years. It chiefly 
affects seamen who make long voyages ; but is not entirely unknown 
on land. 

Symptoms. — Languor, loss of strength, and great depression of 
mind, are among the first signs of scurvy. To one about being at- 
tacked, work and play are alike burdensome. There is no heart even 
to move. The face, and the whole skin, look pale and bloated, and 
the breath has a fetid smell. The gums are swelled, soft, red, and 
spongy ; and they bleed upon the slightest touch, — sometimes the 
blood oozes from them spontaneously. The teeth get loose, and 
often fall out. The skin becomes covered with bluish or purple 
spots, — looking precisely like bruises. These spots spread and run 
into each other, forming large patches of discoloration. 



420 DISEASES OF THE GENERAL SYSTEM. 

These spots appear to be formed by the bursting of the small capil- 
laries of the veins and arteries, which have grown too weak and rot- 
ten to hold their contents, and the infiltration of dissolved blood into 
the cellular substance under the skin. 

Ulcerous sores break out in various parts of the body, which smell 
badly, and discharge a thin matter. These ulcers are covered with a 
crust. Various parts of the body, the bones included, are twinged 
with pains. The pulse is w^eak and soft. All the secretions, includ- 
ing the urine, have an offensive smell, — as though the whole body 
were approaching putridity. In truth, the whole man seems to be 
disintegrating, decaying ; the flesh becomes soft, and dwindles ; and 
the bones break easily, — being afflicted with a decay approaching to 
rottenness. 

In bad cases, blood is discharged from the bladder, bowels, womb, 
nose, and mouth ; and the smallest exertion is followed by fainting, 
and in many cases, by sudden death. 

Causes. — The disease is owing to the use of food and drink begin- 
ning to be decomposed, and to living long at sea without vegetables 
containing certain acids. Its attacks are likewise encouraged by 
whatever weakens and depresses the nervous system, — as long expos- 
ure to a moist, damp air, particularly when this is connected with 
confinement on board a ship, unclean linens, occasional loss of the 
usual rest, and great fatigue, as in storms. The force of these causes 
is increased by the loneliness, the sadness, and the despondency of 
the sailor's life. 

Treatment, — Sailors are very much protected from the disease 
now, by frequent returns to land, during long voyages, to procure 
fresh meats, vegetables, and water. This practice is very generally 
adopted, particularly by our whale ships, which make long voyages ; 
and the result is, very little scurvy, and general health among the 
men. 

One of the best medicines for the disease is quinine ; it may be 
given in from one to two-grain doses twice or three times a day. 
Gentian and quassia are also suitable remedies ; so is the muriatic 
tincture of iron (73). 

Bat the best of all remedies are fresh and succulent vegetables, and 
also fruits. Spinage, lettuce, dandelion, sorrel, cresses, and the like, 
are among the very best things when they can be had. Lemon juice 
produces the happiest effects. Potatoes are among the very best 
remedies, — particularly if scraped and ate raw. They are also valu- 
able when cooked. Spruce beer is a good antidote ; and may be 
made at sea from the essence. Many kinds of beer may be brewed 
at sea, which are valuable. 

When the bowels are costive, cream of tartar, dissolved in water, 
and drank freely, will be found the best remedy. If there be loose- 
ness of the bowels, morphine, laudanum, a tea made of logwood, or 
geranium, or the tincture of catechu, will be suitable. 

For the spongy gums, a solution of alum applied to them will be 



DISEASES OF THE GEXERAL SYSTEM. 421 

proper, or a mixture of equal parts of tincture of myrrh, catechu, and 
Peruvian bark ; and ulcers may be washed with the same. 

Vinegar, which is an excellent prevention in this disease, may be 
made at sea from molasses and water exposed to the sun. Two 
ounces of nitre dissolved in a quart of vinegar, and given in table- 
spoonful doses, three times a day, is said to be an excellent remedy. 

Every ship, on going to sea, should be supplied with dried fruit, as 
raisins, currants, whortleberries, prunes, etc. ; and should have peas, 
beans, rice, flour, sugar, and molasses. Beside these, ships should have 
essence of spruce and lemon, and dried balm, sage, pennyroyal, and 
other herbs. 

Seamen, when down with this disease, should be moved with care, 
as the spark of life may be easily extinguished. 

Purple Disease. — Purpura Hemorrhagica. 

This has been sometimes ranked as an affection of the skin ; but it 
is not such ; it is rather a disease of the general system. 

Symptoms. — This complaint is known by the appearance upon the 
skin of two kinds of spots ; the one kind are small, round, bright-red 
points, even with the surface, and changing in a day or two to a pur- 
ple or livid color, which are yellowish brown when about to disap- 
pear. This variety of the purples is quite simple, attacking, generally, 
young persons, and in warm weather. It is sometimes tedious in its 
course, but never dangerous. It requires little treatment ; — pure air, 
wholesome diet, with quinia and the mineral acids, make up the chief 
part of it. It may be known by the spots not disappearing when 
pressed upon by the finger. 

The other and more dangerous variety of the disease is attended, 
generally, by faintness, wandering pains, great debility, and the ap- 
pearance upon the legs, arms, and body, of dark-red spots, and irreg- 
ular, livid patches, looking just like the marks of recent bruises. 
These marks are caused by the effusion of blood in patches under the 
skin ; and in this respect, they are just like bruises, only they are pro- 
duced by different causes. 

In the rapid progress of the disease, dark venous blood frequently 
oozes from the tongue, mucous membrane of the mouth, nose, breath- 
ing tubes, ears, vagina, womb, stomach, etc. The other symptoms 
vary in different cases very much, but generally indicate great dis- 
turbance of the system. 

It often runs a very rapid course, but sometimes remains for 
months. 

Treatment, — The bowels are to be kept regular by gentle physic 
(26) (21) (12) (15). 

Iron is a valuable remedy (73). 

Astringents generally have a good effect (156) (159) (279) (305). 
The best astringent in this complaint, is gallic acid, taken in five- 
grain doses, every three or four hours. 



%'^ 



422 DISEASES OF THE GENEEAL SYSTEM. 

The sponge bath, twice a day, with tepid or cool water, and fol- 
lowed with gentle rubbing with a coarse towel, will do much tq 
restore and equalize the circulation in the skin. 

During the active stage of the disease, the diet should be very- 
light, — simple toast-water, rice and arrow-root gruel, and either alum 
or wine whey. 

"While getting well, the patient may have a more nourishing diet, 
consisting of tender fresh meat, broths, etc. ; and must take gentle 
exercise in the open air. 



SURGICAL DISEASES. 



Inflammation. 



Every part of the body, which has vessels and nerves, is liable to 
inflammation. Where there are no nerves, it cannot exist. Many- 
diseases are caused by it. Mechanical injuries, such as cuts, bruises, 
and fractures, produce it. And many other disorders, not caused by 
or causing it in the beginning, become entangled with it in their pro-, 
gress. It is very important, therefore, to understand the nature and 
management of inflammation. It is not always to be looked upon 
as a disease ; it is frequently a simple process of repair, whereby 
nature restores injured parts to health. 

The Si^ns of Iiiflamniation are redness, pain, heat, and swelling, 
though in some cases, these do not all appear. 

Acnte Inflammation. — When the redness, the pain, the heat, and 
the swelling, are clearly marked, and the inflammation is so rapid, 
that it either subsides in a few days, or quickly brings on suppuration, 
or ulceration, or mortification, it is said to be acute. 

Chronic Inflammation. — When it is less painful, and slower in its 
progress, beginning very gradually, and lingering a long time, it is 
then chronic. 

Common, or Simple, or Healthy Inflammation is that which is not 
mixed up with any disease, but is established by nature for some 
salutary purpose. 

Unhealthy Inflammation is that which has been caused by some 
other disease, and is under its control. 

Specific Inflammation is that which seems to vary from all ordinary 
cases, being dependent on a particular state of the system, on an 
animal poison, or a principle of contagion or infection, and a power 
of propagation from one person to another. 

Some of these produce such permanent effects, that those having 
them are not liable to a second attack. 

Inflammation is Primary, or, as the doctors say, idiopathic, when it 
is the original disease. 



424 SUEGICAL DISEASES. 



Inflammation is Secondary or Sjmpatbetic when it is the result of 
some other disorder, which goes before, and produces it. 

It has been explained elsewhere that the different parts of the body 
are connected by little threads or nervous strings which run from one 
to the other. If one part of the body become injured or disordered, 
it uses these nervous threads, as telegraphic wires, to tell other parts 
of its misfortune ; and it sometimes happens, that when the intelli- 
gence conveyed is of a sad and alarming character, the part receiving 
the news is so excited and distressed as to become inflamed. Nothing 
can be more proper than to call this sympathetic inflammation. 

When the inflammation is violent, and is seated upon some impor- 
tant part, the sympathetic action is so great as to disturb the whole 
constitution ; and this general disturbance is sympathetic or symptom- 
atic inflammatory fever. 

The Symptoms are quick and strong pulse, dryness and heat of 
skin, parched mouth, great thirst, scanty and high-colored urine, cos- 
tiveness, disordered nervous system, loss of appetite, anxiety, restless- 
ness, sleeplessness, headache, wandering and confusion of mind, and 
sometimes delirium. This fever John Hunter called a universal sym- 
pathy of the body with the disturbed condition of a part of it. 

It is only by inflammation that a wound is healed, or a broken 
bone repaired. 

Upon the surface of a wound nature pours out a fluid called 
plastic lymph. This is composed of flbrine, — the material of wiiich 
flesh is made, — united with a little of the watery part of the blood, 
chiefly albumen. The watery part disappears soon after it is poured 
out, and the fibrine hardens into a kind of membrane. Through this, 
nature sends small nerves, arteries, and veins, which she uses as 
threads to seiv up the ivound. Fibrine being the chief material with 
which nature constructs our bodies, she of course uses it to repair 
them when wounded, — just as a carpenter, who constructs a floor 
with planks, uses planks to mend it when it is broken through. 

In the case of highly inflamed and swelled tonsils, nature some- 
times becomes alarmed, and, for once making a mistake, she rushes 
in with her material for repair, and fills up all the interspaces with 
fibrine, — thus hardening the glands, and making their cure impossi- 
ble without cutting them off. But in most cases, nature is right, and 
cures the injury by inflammation. 

Buify Coat of the Blood. — The effects of inflammation extend to 
the blood. This fluid, w^hen drawn from the veins of a person suffer- 
ing from an inflammation active enough to disturb the constitution, 
forms a clot in the basin more slowly than usual, but the clot is 
harder ; and a layer of fibrine is left upon the surface of a yellowish 
huff color, looking like size or glue, and called the biffy coat. The 
clot is also scooped out in the centre, and the blood is said to be 
cupped. 

Coin Discs. — It is another peculiarity of inflamed blood, that if 
a drop of it be examined under a powerful microscope, its globules, 



SUKGICxVL DI&tiASES. 425 

or dUos?, which are very numerous, will be found standing on their 
edges, and leaning against each other, like a row of copper or silver 
coins. (Fig. 144.) 

Inflammation may end in one of four different ways. 

I. By Resolution. — Suppose a large splint of w^ood be stuck into 
the hand of a healthy man. It causes redness, heat, swelling, and 
pain ; and these, combined, are inflammation. The splint is pulled 
out, and the hand well done up with a water dressing, and properly 
cared for. The redness fades, the heat declines, the swelling sub- 
sides, and the pain disappears ; the inflammation is ended, and the 
hand is well. Coming to a fortunate end in this way, inflammation 
is said to be resolved^ or terminated by resolution. 

Fio. 144. Flo. 145. 





n. By Suppuration. — It does not always end so happily. The 
splint may be broken off below the skin, and not pulled out ; and 
proper means may not be used to subdue the inflammation. Instead 
of abating, it may increase ; and the centre of the injured part may 
begin to rise up to a point, and grow white on the top. This shows 
that there is matter formed underneath, which is lifting up the scarf- 
skin, and seeking to come through. Fig. 145 is a microscopic view 
of pus corpuscles. 

The pain is now very throbbing and pulsating, — keeping time 
with the beats of the heart. When the scarf-skin can hold out no 
longer, it breaks, and yellow, cream-like fluid runs out, which we 
call pus. The redness, pain, etc., now subside. This process we call 
suppuration. 

At this time, if the wound have been a severe one, attended by 
sympathetic fever, and the discharge of pus be now large, there may 
be a change in the fever, marked by frequent shiverings and chilli- 
ness, followed by flushes of heat, which ends in sweating. We call 
this hectic fever. 

in. By Ulceration, or the formation of open, ruiming sores. 

IV. By Mortification. — If the wounded part have been so much 
injured as gradually to destroy its vitality, it dies. The vivid red of 
the inflammation changes to a purplish, or livid, or black hue. The 
strained condition of the skin ceases, — a bloody fluid lifts up the 

54 



426 SURGICAL DISEASES. 



cuticle, — the pain and feeling are all gone, — the part is dead and 
putrid, and gives out a peculiarly offensive smell. This process is 
called mortification. 

The mortified and dead part is called a slough ; and it is separated 
from the living parts by a peculiar vital process which has the name 
of ulceration. 

Treatment of Inflammation. — Though inflammation sometimes 
ends kindly by resolution, and though it is often a salutary process, 
yet it is frequently very destructive, — ending in suppuration, ulcera- 
tion, and mortification, — thickening, hardening, softening, and en- 
larging parts affected by it ; and doing these things in textures of 
great delicacy, and of vital importance in the economy of life. It 
calls, therefore, for judicious, and, often, for very active treatment. 

There are two principal things to be done, — to remove the cause, 
if it be still active, and to take the blood away from the inflamed 
part. 

K a bullet be lodged in the flesh, or a thorn, or a splint of wood, 
or a piece of glass, it is the exciting cause of the inflammation which 
follows, and little can be done to advantage, till the offending sub- 
stance is extracted. If inflammation be excited in the bladder by 
the irritating presence of urine, which cannot be passed, this must 
be drawn off with the catheter, before relief can be had. If the 
stomach be inflamed by improper food, or too much of it, the diet 
must cease to follow appetite, and take reason for its master. If 
ladies have excited inflammation in the bowels, or any of the internal 
organs, by a dragging weight of skirts, they must either put off the 
burden, or hang it upon the shoulders with straps. 

The blood is removed from the inflamed part in two ways — 

Cupping and Leeching. — It is done directly by cupping and leech- 
ing. These methods take the blood out of the small vessels, which 
are so full and crowded as to produce pain. Cold water, ice, etc., 
applied to the part, cause these little vessels to contract, and squeeze 
the blood out of themselves. These are very useful applications ; 
and they are to be pursued as long as there is any hope of break- 
ing up the inflammation, or causing it to end by resolution. But 
when this is no longer to be expected, and it is found that it will go 
on to suppuration, then apply warm fomentations and poultices. 
These will moUify and soften the parts, and cause the suppurating, 
or, in common language, the rotting process, to go on more rapidly, 
and with less pain. 

Counter-Irritation. — The other method of removing the blood 
from the inflamed part is by what is called counter-irritation. 

People are apt to think it very absurd that inflammation should be 
induced in one place to relieve or cure it in another. But it is not 
absurd. It relieves or cures on the principle of sympathy, which I 
have already explained. We put croton oil, or tartar emetic, or 
Spanish flies, or cayenne pepper, or mustard, upon the surface of the 
bowels when the internal parts are dangerously inflamed, and what 



SURGICAL DISEASES. 427 



is the result ? Why, the terrible smarting and pain alarms nature, 
and she rushes up to the surface with a large amount of the blood 
around the inflamed parts, and there, for hours, perhaps for days, 
struggles to beat down the new mischief at the surface ; and, in the 
mean time, the internal parts, relieved by the removal to the surface 
of so large a quantity of hot blood, make a long stride towards re- 
covery. 

A popular orator is speaking to a multitude in a hall which is 
thronged to excess, and a few feeble persons faint, and are likely to 
be suffocated and trodden upon in the dense mass. A person at the 
door, seeing what has happened, cries "^re." The crowd rush out ; 
the fainting persons get breath, and are saved. So, when the thou- 
sand streams of blood rush through their channels upon an inflamed 
and fainting internal organ, crowding and oppressing it, we set the 
skin on fire with some inflammatory substance ; the blood rushes to 
the new point of excitement, and the oppressed and fainting organ 
recovers. 

Cupping and leeching, which are often necessary, are not to be 
resorted to in very debilitated constitutions. In some persons, leech- 
ing produces erysipelas. 

Costiveness is always produced by the symptomatic fever which 
often results from inflammation. This should be removed by saline 
purgatives, such as rochelle, epsom salts, glauber's salts, salts of tartar, 
tartrate of potassa, and the tartrate of soda (9) (7) (12) (14) (18) (20) 
(25) (27) (41). Sometimes more active purgatives are required, and 
then the compound extract of colocynth, etc. (29), will be excellent, 
or, five grains of blue pill, at night, followed by (299), may be used. 

As a drink, cream of tartar (298) will be found cooling and re- 
freshing. In all inflammations, the diet must be light and unstimu- 
lating. 

Suppuration and Abscess. 

An abscess is the collection of pus or matter in the substance of 
some part of the body. When the matter is poured out from some 
part, the process is said to be suppuration; when it collects in a 
tissue, it is an abscess. When the matter collecting in some organ, 
comes towards the surface, and a place in the centre rises above the 
surrounding skin, and turns white, the abscess is said to point. Some 
abscesses point and break in a week ; others of a more chronic char- 
acter, will linger on for months. 

Fluctuation. — Before an abscess points, ^fluctuation may generally 
be felt in the swelling, which is one of the surest signs that it con- 
tains pus. Sometimes this fluctuation may be felt even when the 
matter lies very deep in the flesh. And when it is so deep that it 
cannot be felt, if a sudden cessation of the symptomatic fever should 
occur, and shivering-s or rigors should come on, attended by coldness 
in the affected part, we may reasonably suspect that pus is formed. 
It is not easy, at times, to say whether matter is really present ; and 



428 SUKGICAL DISEASES. 



great care should be used not to plunge in a lancet where none 
exists. 

Treatment. — When the abscess is completely formed, and there is 
no longer any doubt of the presence of matter, it should be opened 
at once. To let out the confined pus alleviates the pain, and lessens 
the inflammation. If the matter lie close to a bone, the opening 
should be made without delay. The opening should be large enough 
to let the matter out freely. It is a rule to keep the incision open 
till the cavity of the abscess is so far filled up that another collection 
of pus is not likely to occur. 

If the matter do not readily get to the surface through the opening, 
it may burrow itself in the flesh, in a long narrow channel called a 
sinus. To relieve this, the opening must be extended in such a way 
as to give vent to the new collection. 

An abscess is sometimes indisposed to heal at the bottom, and pus 
continues to be formed a long time, and is discharged through an 
opening smaller than the sack which contains it. This is a^s^z^/c^; 
and the opening to it should be enlarged so as to let out the matter 
more freely. A little soft lint may then be gently pressed into the 
wound to prevent its healing before the cavity below. 

An abscess from acute inflammation requires to be poulticed for a 
time after it has been opened. When the swelling and inflammation 
are gone, the poultices are to be laid aside, and a bandage put on. 
When the inflammation is gone, let the diet be improved ; and if the 
discharge of matter be large, give wine and tonics. 

Mortification. 

The complete death of a part of the body, and its change into a 
black, stinking, cold, and insensible mass, with which the other parts 
of the system have discontinued all organic connection, is what we 
call mortification. That form of it which is most common, is said to 
be humid, on account of the moisture of the dead parts. 

GangTene. — Before the mortified part is completely dead, and, 
consequently, while its recovery is supposed to be possible, the con- 
dition of the part is called gangrene. 

Sphacelus is the name given to it after its entire death. 

Slouching is the process of separating the dead matter, and the 
substance separated is a slough. 

The causes of mortification are quite numerous. The most com- 
mon are, stoppage of the circulation by inflammation, by mechanical 
causes which obstruct the passage of the blood, by chemical agents 
and poisons, and by local or general debility. 

In a bad constitution, which bears disease poorly, mortification is 
very dangerous. 

Treatment. — In treating mortification, three things are to be aimed 
at, — to stop its progress, to promote the separation of the dead from 



SUEGICAL DISEASES. 429 



the living parts, and to heal the ulcer which is left after the separa- 
tion. 

To stop the progress of mortification, we must remove its cause. 
If it be inflammation, treat that according to the principles laid down; 
though leeching, purgatives, etc., should be used sparingly, as mortifi- 
cation reduces the constitution so rapidly that it does not bear reduc- 
ing as well as usual, and sometimes not at all. As soon as the in- 
flammation has subsided, particularly if the system be weakened, 
tonic bitters and a nourishing diet must be had. "When there is 
fever, with great excitement of the nervous system, delirium, picking 
of the bed-clothes, etc., the patient should have anodynes (121) and 
antispasmodics (87) (91) (90), with blisters upon the back of the 
neck, drafts upon the feet, and such other local remedies as the case 
may require. 

It is of little use to put anything upon the mortified part, except 
with a view of lessening the stench. For this purpose, lay upon the 
part lint soaked in a solution of chloride of lime or soda, or a solution 
of pyroligneous acid, or of creosote. 

Very little can be done to hasten the separation of the dead part 
from the living ; but while it is taking place, a common flax-seed 
poultice, mixed with a little powdered charcoal, may be kept on it. 

The ulcer left after the separation is to be treated like other 
ulcers. 

Ulceration and Ulcers. 

When the small particles composing the body have been used 
awhile, they wear out, and become useless. Over the whole body 
are distributed a multitude of small vessels, called absorbents, whose 
business it is to pick up these worn and loosened particles^ and carry 
them away. 

There is another class of small vessels, having just the opposite 
duty, — namely, to bring new particles of matter, and put in the 
places of those taken away. These are arteries. They are the natu- 
ral artisans, who construct our bodies. The absorbents are the de- 
molishers who pull them down. Under these two forces, our existence 
is, for a time, a drawn game between life and death. The absorb- 
ents, like myriads of hungry insects, eat us up, — the constructing 
arteries, like faithful builders, reconstruct us. The work of the ab- 
sorbents, is called absorption ; that of the constructing arteries nutri- 
tion. 

When nutrition partially ceases, and absorption continues una- 
bated, we grow thin, or lose flesh. This happens in consumption. 
If nutrition should stop altogether, absorption going on as usual, our 
bodies would be quickly destroyed. We should be wholly devoured 
by these little absorbent vessels. This would be ulceration applied to 
the whole body. But it does not appear in so general a form. It 
confines itself to particular parts. 

When nutrition entirely ceases in any portion of the body, the 
absorbents devour all the skin, flesh, and vessels of the part, — leaving 



430 SURGICAL DISEASES. 



an open cavity. The process of taking away the flesh, etc., is ulcera- 
tion^ — the cavity left is an ulcer or sore. 

Natural Surgery. — Ulceration sometimes acts the part of a natural 
surgeon. When a part dies from mortification, it is necessary to 
have it removed ; so nature sets up, directly around it, an acute in- 
flammation, in which all nutrition stops, and absorption goes on 
rapidly. In this way, a complete dike is in a short time made around 
the dead mass, and it is as handsomely amputated, or cut off, as any 
surgeon could do it. 

When the ulceration is going on, and the blood-vessels are being 
cut off by it, the blood coagulates or curdles in them for a short dis- 
tance back from the breach, which prevents bleeding. This is as 
good as tying the arteries. 

Some textures ulcerate more easily than others, — the skin and 
mucous membranes most easily of all. 

Ulcers are divided into healthy^ unhealthy^ and specific, 

A Healthy ulcer is a simple sore, not showing any bad symptoms, 
but rather a kindly disposition to heal. It is generally small in size, 
of a florid-red color, and has upon its surface, little elevations, pointed 
like cones, called granulations^ which are not so apt as in the case of 
unhealthy ulcers, to rise above the level of the surrounding skin. 

Unhealthy Ulcers comprise those called irritable^ indolent^ and pha- 
gedenic, etc. 

Indolent Ulcers are numerous. The edges of the skin around 
them are generally thick, prominent, and rounded. The granulations 
are pale, smooth, large, and flabby, with a peculiar gloss upon them. 
These ulcers form most often on the leg ; and the nearer they are to 
the ankle, the harder they are to cure. 

Phagedenic Ulcers are those which look as though they literally eat 
away the parts. Their surface has a livid appearance. The matter 
formed is small in quantity, and is frequently tinged with blood. 

Specific Ulcers embrace scrofulous, cancerous, venereal, scorbutic, and 
others. They are called specific because they are produced by par- 
ticular diseases, and states of the system. 

Treatment. — The first thing to be done is to remove the exciting 
cause. A venereal, or a scrofulous, or a scorbutic ulcer, cannot be 
cured, unless we first lessen the force of the disease in the general 
system. If the continuance of a sore depends on bad digestion, we 
cannot expect to cure it, till we put the stomach right. 

Healthy ulcers want no treatment, except some simple dressing, 
such as marshmallow or spermaceti ointment. It is well, in some 
cases, to touch the granulations near the surface, with lunar caustic. 

Ulcers upon the legs and ankles do not heal well if the patient 
walks about much, or even allows the legs to hang down a great 
deal. 



SURGICAL DISEASES. 



431 



Fig. 146. 



Indolent ulcers are to be touched by lunar caustic stick, or by 
diluted nitric acid. The diluted ointment of the nitrate of mercury 
is also often used with benefit. So is the com- 
pound tincture of benzoin ; the basilicon ointment, 
etc. Or, apply a bread and milk poultice to the 
ulcer, and keep the patient twenty-four hours in 
bed. Then apply the lunar caustic stick to the 
whole sore, and to the skin around it. Afterwards 
cover the ulcer with sticking plaster, and a bandage. 
The following is the best plan. Lay upon the 
sore a number of pieces of lint, soaked in the ni- 
tric acid lotion (314), and cover them with a bread 
and milk poultice. Change these applications twice 
a day, and continue them till the discharge looks 
healthy, and the granulations begin to appear. 

If there is inflammation about the sore, give some 
of the preparations of salts to purge the bowels, and 
confine the patient to bed. When the parts begin 
to look healthy, lay some pieces of lint upon the 
sore, wet with nitric acid lotion (214), or zinc lotion 
(215) ; and then apply strips of adhesive plaster, 
one and one-half inches wide, two-thirds round the 
limb, and extending an inch below the ulcer, and an 
inch above it, — at the same time, drawing the 
edges of the sore together with a gentle force, and 
retaining them there with the plaster. Put a compress of soft linen 
over the plaster, and apply a bandage over the whole, making it tighter 
below, and a little looser above, and extending to the knee. (Fig. 146). 




Boils. — Ferunculus, 



Underneath the skin is a layer of tissue composed chiefly of cells. 
From this tissue there are small elevations, in the shape of cones, 
which rise up into the substance of the true skin. Like those papillae 
of the skin which become inflamed and produce corns,, these eleva- 
tions are subject to an inflammation, which causes hoils. 

At first, a tender knot or hardness is felt just under the skin, which 
soon begins to look red. A painful tumor now begins to show itself, 
of a dusky red or purple color, which acquires the size of a pea, a 
hazel-nut, or a walnut. Sometime between the fourth and eighth 
day, it becomes pointed and white at the top, when the scarf-skin 
gives way, and lets out a little pus mixed with blood, and exposes to 
view a mass of dead matter, called a core^ which is too large (or the 
opening, and is not ready to come away, if it were not. This core is 
a mass of mortified or dead flesh ; and nature is cutting a space 
around it, that it may be thrown off! In two or three more days, it 
comes away, leaving a cup-like cavity, which gradually fills up, and 
the boil is over. 

Some costitutions yield boils in successive crops. When this hap- 



432 SURGICAL DISEASES. 



pens they are a terrible affliction. There are not many Jobs who can 
bear them with patience. 

Treatment. — A boil will generally ran its course. A five-grain 
blue pill, taken at bed-time, when the boil is first showing itself, is 
about the only thing I know that will blast it. And yet, my unwil- 
lingness to encourage a general use of mercurials, makes me hesitate 
to recommend it. One pill, not to be repeated, can do no harm, how- 
ever, and may safely be taken. 

Boils may sometimes be stopped by touching them with lunar 
caustic. Water-dressing, if used early, and persevered in, will some- 
times prevent their growing larger than a pea. After the boil has 
opened, apply poultices for a day or two, then some simple, stimu- 
lating ointment, as basilicon salve, or Turner's cerate, or nitric acid 
lotion (314). If boils corftinue to come out in successive crops, give 
alterative medicines, or sulphurous mineral waters, or liquor potassse, 
or bicarbonate of soda. 

Carbuncle. — Anthrax. 

This is like a boil, only much larger, and more painful. Instead 
of one of the little cellular elevations being inflamed, as in the case 
of the boil, the carbuncle begins with the inflammation of several. 
Its surface is more flat than that of a boil ; its inflammation more 
violent ; and the constitutional symptoms excited more severe. It 
has the breadth, sometimes, of the top of a quart bowl. Like the 
boil, it appears most often upon the neck, the shoulders, the back, the 
buttocks, the thighs, etc. It goes through the same process as a boil, 
and ends in the same way, only discharging a vastly larger core. 

Carbuncles most often appear in persons above middle age, and 
indicate an impaired and broken constitution. They occasion great 
suffering, and sometimes prove fatal. Upon the head or neck, they 
are more dangerous than in other situations. 

Treatment. — Apply, constantly, during the formation of the carbun- 
cle, either fomentations and poultices, or cold water dressing. I pre- 
fer the latter. To stop both the local and the constitutional disorder, 
make two incisions in the form of a cross, cutting entirely through 
the dead mass. Then apply a fermenting poultice, or one of oat- 
meal, for two or three days, — after which, use the basilicon salve, or 
apply daily a weak solution of lunar caustic, or the nitric acid lotion 
(314). During recovery, tonics are useful, such as quinine, tincture 
of Peruvian bark, and sulphuric acid ; and morphine to procure rest, 
at every stage when it is required. 

Malignant Pustule. 

This is one of the five diseases which man may take from animals. 
The other four are the cow-pox^ hydrophobia^ glanders^ and pestilential 
carbuncle. This last is what the French call charbon, — pronounced 



SURGICAL DISEASES. 433 



sharbo. My own mother and an elder brother came near losing their 
lives by it, — having taken it by handling the flesh and tallow of a 
dead cow. 

Malignant pustule begins with a water-pimple, not bigger than a 
millet seed. Underneath it is a hard point, surrounded with redness, 
like a flea-bite. This hardness is soon attacked by mortification, 
which spreads on all sides, and kills everything as it goes. Next, in 
fatal cases, come great restlessness, faintings, sunken countenance, 
dry skin, dry brown tongue, despondency, delirium, and death. It is 
supposed generally not to arise from constitutional causes, but to be 
produced by a specific poison applied to the skin, or by eating the 
ilesh of cattle which die of gangrenous diseases. The disorder is 
probably the same with the pestilential carbuncle. 

Treatment. — Deep incisions, and the application of the most pow- 
erful caustics, as the caustic potash, etc., and tincture of peruvian 
bark, quinine, aromatic sulphuric acid, wine, ether, and opium. 
Probably the best treatment is to surround the pustule with a thick 
layer of ointment ; then to fasten some lint to the end of a stick, wet 
it with nitric acid, and press it upon the pustule. Now apply cloths, 
wet with cold water, and when the slough comes off, dress with 
simple ointment, or touch occasionally with weak solution of nitrate 
of silver (211). 

Chemical Injuries. 

These are of two kinds, produced by causes of an exactly opposite 
nature. The first are 

Burns and Scalds. 

A burn is the effect of concentrated heat acting upon living tissues. 
The effects are inflammation, and sometimes complete disorganization 
and destruction of the parts. 

A scald is an injury produced by applying hot water or other fluid, 
to the skin or mucous membrane. The natural temperature of the 
human body is ninety-eight degrees ; that of boiling water, two hun- 
dred and twelve degrees. Bringing the skin in contact with a fluid 
heated so far above it, produces redness and pain ; and when nothing 
is done instantly to ward off the injury, the scarf-skin is raised from 
the true skin in the form of a blister, filled with water. 

The degree of danger from a burn or scald, depends upon the ex- 
tent of the injured surface, and also upon the depth of the injury. An 
extensive scald or burn may prove fatal in a few hours, — the patient 
never rallying from the first prostration. These injuries are most 
dangerous when upon the head, neck, chest, and belly. Old persons, 
and those who are feeble, and have shattered constitutions, will sink 
under burns and scalds, from which robust persons will suffer but 
little. 

Treatment — For slight burns and scalds, make cold applications. 

'55 



434 SURGICAL DISEASES. 



Put the injured part in very cold water, or lay upon it pieces of linen, 
or lint, wet with vinegar and water, or rose water and sugar of lead 
(238), or diluted solution of acetate of ammonia. When these are 
not to be quickly had, lay on scraped potatoes. The object is to 
reduce the inflammation, and to prevent blistering. They must, 
therefore be put on very soon. If the scald be extensive, and on the 
body, — producing shivering, faintness, paleness, and coldness of the 
skin, and a small pulse, — cold applications are not proper. In such 
case we may use warm fomentations, or, in the case of a child, the 
warm bath. A liniment of spirits of turpentine, linseed oil, etc. 
(194), makes an excellent application. 

Raw cotton, spread out thin, and laid upon a burn, is a good dress- 
ing, and one which is much used. So is flour sprinkled upon the 
injured surface with a dredger. For loosening the flour when it is 
to be taken off", poultices are useful. 

Keep the air from the wound as much as possible. "With this 
view, do not remove the dressing often, and when a cold lotion is 
used, merely pour it upon the rags, letting them remain undisturbed. 

Effects of Cold.— Frost-Bite. 

Cold is a relative term. The same temperature may be called hot 
or cold, according as it is compared with a hotter or colder tempera- 
ture. If we warm one hand by a fire, while we lay the other upon 
ice, and then plunge them both into cold water, the water will feel 
cold to the one which has been by the fire, and warm to the one taken 
from the ice. 

The warmth of the body being ninety-eight degrees, any tempera- 
ture below this may be said, in a certain sense, to be cold. Yet a 
temperature much lower than this, namely, from sixty to seventy, is 
the most agreeable and invigorating, because it takes away the heat 
just about as fast as it is produced in a healthy body. 

The first effect of cold applied to the body is to weaken the circu- 
lation in the small blood-vessels of the skin. When applied with 
some intensity, the heart and arteries in general are weakened ; the 
blood is delayed in the vessels near the surface, and not being 
changed to a red color in the lungs as fast as it should be, the fin- 
gers, ears, etc., become blue or livid ; and, if the cold be continued 
sufficiently long, the circulation stops in these parts ; heat ceases to 
be evolved, and mortification or death is the consequence. Parts 
killed in this way are said to he frost-bitten, 

A free circulation of red blood is essential to the continuance of 
sensibility. Hence, when the circulation is seriously impeded by 
cold, the body becomes numb, — it loses its feeling ; the muscles act 
feebly ; a languor and torpor follows ; drowsiness comes on, followed 
by sleep, from which there is no waking. Drowsiness, during expos- 
ure to extreme cold, indicates great danger. 

Treatment. — It is a great principle in restoring frost-bitten parts, 
and persons benumbed with cold, to communicate heat in the most 



SURGICAL DISEASES. 435 



gradual manner. Mr. Hunter says the degree of external heat should 
be in proportion to the quantity of life. When life is weakened and 
nearly destroyed by frost, therefore, the warmth imparted must be 
small, and rise no faster than life returns. 

To restore a frozen limb or part, rub it with snow, or place it in 
cold water for some time. When feeling begins to return, still keep it 
in cold water, and let heat be added in a very gradual manner, by 
poring in, now and then, a very small quantity of warm water. 

If a person be reduced by cold to insensibility, and apparently 
frozen to deaths take his clothes off, and cover him all over with snow, 
except the mouth and nostrils. If snow is not to be had, put him in 
water as cold as ice, and let him lie for some minutes. Then rub 
him wdth cloths wet wdth cold water. When the body is thus thawed 
by degrees, and the muscles begin to relax, dry the body, and placing 
it in a cold bed, rub with the warm hands, only under the clothes. 
Continue this for hours. If signs of life appear, give a small injec- 
tion of camphor and water, and put a drop of spirits of camphor on 
the tongue. After a time, rub with spirit and water, and finally with 
spirit, and give tea, or coffee, or brandy and water. 

Mechanical Injuries. 

Wounds are divided into several kinds. 

Incised Wounds are very common. Being made with sharp instru- 
ments, they are cuts^ and have no laceration or tearing about them. 

Stabs, or Punctured Wounds, form another class. They are made 
with pointed weapons, as bayonets, lances, swords, and daggers. 
They are more dangerous than the former, because they penetrate 
to a greater depth, — injuring blood-vessels, nerves, bowels, and other 
organs. 

Contused and Lacerated Wounds form still another class. They 
embrace gun-shot wounds, and all those produced by blunt instru- 
ments. They tear^ and bruise^ and mash the flesh. 

Poisoned Wounds form yet another class. They are such as are 
united with the introduction of some venomous poison into the in- 
cised, or punctured, or contused part. Stings and bites of venomous 
insects and snakes are of this class, — also the wounds made by poi- 
soned arrows. 

Simple Wounds are such as are inflicted on a healthy subject with 
a clean sharp instrument. 

Complicated Wounds are those inflicted when the state of the 
whole system, or of the wounded part, is such as to make it neces- 
sary for the surgeon to deviate from the treatment needed for a 
simple wound, — as, for example, when there is bleeding, or nervous 
symptoms, or great pain, or locked-jaw, or much contusion, or ery- 
sipelas. 



436 



SURGICAL DISEASES. 



Sympathetic Fever, — All large wounds are followed by symptom- 
atic fever, which comes on from sixteen to thirty-six hours after the 
accident. This is generally of the inflammatory kind, and is indi- 
cated by greater warmth of the skin, a more frequent and stronger 
pulse, anxiety, thirst, and loss of digestive power. Where much 
blood is lost, and the constitution is feeble, the pulse is more quick 
than strong, and the fever of a lower and more typhoid type. In 
this case, blood must not be drawn. 

Lacerated wounds are more dangerous than incised ones, because 
the parts are stretched and otherwise injured, besides being separated. 

A very small wound upon the brain, the spinal marrow, the bowels, 
or the heart, will often prove fatal, because the functions of these 
parts are intimately connected with life. 

Wounds of young persons heal much more rapidly and kindly than 
those of old persons. 



Incised Wounds. 



Fig. 14' 



When the flesh is divided with a cutting instrument, the cut edges 
separate, and the wound has a gaping appearance. This drawing 
apart happens in consequence of the elasticity of the skin. It often 
happens that vessels of considerable size are cut, so that bleeding is 
the principal thing to receive attention. 

Treatment of Hemorrhag'e. — Bleeding is stopped by the tourniquet, 
by the ligature, by compression, by the application of cold ivater and 
ice, and by astringents and styptics. 

The Tourniquet. — This instrument consists of a band and buckle, 
a pad, and two brass frames, the upper of which is furnished with 
two small rollers, and the lower 
with four, over all of which the 
band plays. When the handle is 
turned to the right or left, the 
band is tightened or relaxed to 
just the extent required. (Fig, 
147.) The band is buckled round 
the limb in such a manner that 
the pad is placed exactly over the 
artery. When an artery is cut, it 
is known by the blood being very 
red, and spirting out in jets ; and 
in this case, the instrument must 
be placed upon the limb above 
the wound, or between it and the 
heart. 

The Li^ture. — When an artery 
is divided, the surgeon lays hold 
of the end of it with his forceps, and ties a thread tight around it 
This is called a ligature. By it, the bleeding is instantly stopped ; 




SURGICAL DISEASES. 437 



and long before the thread becomes loose, the opposite sides of the 
vessel have grown together, and all danger of a renewal of the 
bleeding is over. 

Application of Water ami Ice. — This is done by saturating with 
cold water several folds of linen rags, or lint pads, and applying them 
to the wound, remoistening, and reapplying them as fast as they be- 
come hot, till the pain and inflammation subside. 

Compression. — When the blood does not come from any large 
vessel, but from several small ones, compression is suflicient. It con- 
sists in placing the opposite sides of the wound together, if possible, 
and then laying compresses over, and applying a bandage with mod- 
erate tightness. 

Astringents and St}i)tics, — These are spirits, tinctures of myrrh, 
Peruvian bark, diluted mineral acids, solutions of tannin, alum, sul- 
phate of copper, decoctions of white oak bark, etc. These have the 
power to stop bleeding from small vessels. Monsel's salt, a remedy 
just coming into use, is said to have more power than all the above. 
It is a preparation of iron and nitric acid, and has been used with 
great success in stopping violent bleeding at the military hospital of 
Bordeaux. It is not a caustic or an irritant ; but it acts very power- 
fully upon albumen and blood, — producing "with the latter a large 
clot, absolutely insoluble^ which continues to enlarge for several hours 
after the application, and becomes quite hard and firm, so that no 
blood can get through. 

Beside these means, the application of the lunar caustic stick, 
potash, and the hot iron, are used, particularly the first, quite often. 

Union by the First Intention. 

When the bleeding is stopped, all foreign substances removed, and 
the wound properly cleansed, the next thing is to bring the opposite 
sides of the cut evenly together, and to keep them steadily in this 
position till they have healed. If this method succeeds, the healing 
takes place without the formation of any pus. This is called healing' 
by the first intention^ or adhesion. The cut surfaces grow together. 
For keeping the surfaces together, straps of adhesive plaster are used, 
putting them at right angles across the cut, and leaving spaces be- 
tween them. Over the straps should be cold water dressings. 

Sutures. — Incised wounds are sometimes, — though seldom now, — 
sewed together^ by what is called the interrupted suture. After the 
bleeding is stopped, a curved needle is threaded, and, the lips of the 
wound being brought together, is introduced through the right lip, 
and then, being directed across the wound, is pushed through the left 
lip, from within outward. It is now cut off, and tied in a bow. 
These stitches should be at least an inch from each other. The 
adbosive plaster is generally better than the suture. 

The first plasters and dressings should remain on the parts at least 



438 SURGICAL DISEASES. 



three or four days, unless very great pain, bleeding, or some other bad 
symptom, should call for their removal. 

Useful Eules for Examining and Dressing Wounds. 

Never give the patient more pain from the mode of handling and 
dressing the wound than is necessary for his present good, or future 
safety. Never distress him by probing, squeezing, etc., to find things 
that will be of no use when learned. 

Make all examinations as soon after the accident as possible ; for, 
before inflammation and swelling take place, the probe or finger in- 
flicts much less pain. 

In changing the dressing of a wound, let all the fresh ones be ready 
before the removing of the old. The sponge, warm water, adhesive 
plaster, lint, ointment, lotions, bandages, etc., should all be at hand, 
and not have to be looked after when the wound is exposed. 

Put the patient in the most easy position, that he may not be need- 
lessly fatigued during the dressing. 

If the bandage, plaster, and other dressings, have become hard, and 
glued together, and to the skin, by blood or matter, soften them with 
warm water, which is to be pressed out of a sponge, — a basin being 
held below the part to catch the water as it falls from the dressing. 

The strips of adhesive plaster are to be removed by pulling gently 
at one end, and then the other, — each to be drawn towards the 
wound, so as not to pull its lips apart. 

In large wounds, take off" one, or at most, two strips of plaster at 
a time. Cleanse, wipe dry, and again support this part of the wound 
with new strips of plaster, before any more are taken off". This will 
prevent the wound being torn open by the weight of its parts. 

If the wound be large and deep, its sides should be supported by 
an assistant while changing the dressings. 

If there are several wounds, dress but one at a time, that there may 
be no needless exposure to the air. 

Pay the utmost attention to cleanliness. 

The frequency of the dressing must depend on the amount and 
quality of the discharge, the situation of the injury, the climate and 
season of the year, the effect produced by the dressing, and by the 
feelings of the patient. 

The Way in which Wounds Unite. 

When the two surfaces of a wound are brought together, they bo- 
come impervious to the blood, but not to coagulable lymph, or fibrine. 
This, — the material of which all flesh is made, — flows out upon the 
two surfaces, and becomes a bond of union between them. 

Into this layer of fibrine, the small blood-vessels, — arteries and 
veins, — which have been cut asunder, push themselves with open 
mouths, and, meeting in the centre, they inosculate, or grow together, 
and the blood resumes its circulation through them. 



SURGICAL DISEASES. 439 



By this method, incised wounds of moderate size are often healed 
in forty-eight hours. This method of healing by the first intention 
is always to be brought about, if possible. 

Punctured Wounds. 

These are produced by swords, daggers, etc. 

Great swelling and inflammation, large abscesses, erysipelas, the 
wounding of large arteries, and the consequent extravasation of blood, 
symptomatic fever, and lock-jaw, are the frequent results of punc- 
tured wounds. They are, therefore, more dangerous and hard to cure 
than cuts. 

Treatiiieut, — For the first twenty-four hours, use superficial dress- 
ings of lint, wet with a solution of sugar of lead dissolved in cold 
water, or with cold water simply, and a loose bandage. If, after this, 
pain and -swelling should increase, leeches may be applied to the 
neighborhood of the wound, and fomentations, or poultices, be put in 
place of the cold water, — placing a small linen rag, spread with sper- 
maceti cerate, over the wound. When the pain and inflammation 
are great, saline purgatives (7) (18) (25) (27), and opiates are often 
called for. 

Contused and Lacerated Wounds. 

These are produced by cudgels, stones, bullets, or whatever else of 
a blunt nature, tears asunder the muscular fibres, leaving jagged and 
uneven surfaces. They are rarely healed without suppuration, and 
are frequently followed by violent inflammation. They suppurate 
and slough, but they do not bleed much, — not even, sometimes, when 
large arteries are torn asunder. Whole limbs are occasionally torn 
away without hemorrhage. In warm climates, lock-jaw is a frequent 
consequence of them. 

Treatment. — Draw the edges of the wound loosely together, and 
retain them with a few strips of adhesive plaster. Sometimes a 
suture, here and there, will be proper. If a great deal of inflamma- 
tion ensues, take away the adhesive plaster and the stitches, and 
apply a poultice, or water dressing ; and if there be much fever, rest- 
lessness, or delirium, saline purgatives (18) (25), opium (118), and 
very low diet, will be needed. 

The wound having thrown off" its sloughs, suppurated, become 
clean, and formed granulations, the poultices are to be taken off*, and 
simple dressings substituted. These should be adapted to the condi- 
tions of the sore, according to the directions for treating ulcers. 

When the wound is so severe that extensive mortification will be 
sure to follow, the limb must be immediately taken off", to save the 
life of the patient. 



440 SURGICAL DISEASES. 



Granulation and Scarification. 

Suppurating wounds heal in the same way with ulcers. The 
chasm is filled up by the appearance of little soft elevations of new 
substance, which originate at all points, and meet at the centre, draw- 
ing the sides nearer together, and raising the bottom towards the 
surface. This is called granulation^ because these elevations look like 
grains ; and the result is a new tissue, of a peculiar character, which 
constitutes the cicatrix, or scar. 

Reproduction of Lost Parts. 

Among some of the lower animals, whole limbs which have been 
destroyed, are easily reproduced. It is not so with man ; though cer- 
tain parts, when only partially destroyed, are sometimes regenerated. 
Thus, portions of skin, of considerable extent, are often reproduced ; 
and so are the whole of some long bones, when destroyed by necrosis. 
The same is true, to some extent, of ligaments. But portions of 
brain, and spinal marrow, and muscle, and mucous membrane, when 
once removed, are never regenerated. 

Gunshot Wounds. 

At a time when fire-arms are so much carried about the person, 
and so often used for purposes of duelling, and murder, it is proper 
that every person should know something of the modes of treating 
gunshot wounds. 

Treatment. — It is often proper to make a gunshot wound larger at 
the orifice. When this is done, it is generally on the side where the 
bullet has passed out, if it has gone entirely through. A bullet is 
always to be removed, if it can be felt. 

The dressings are at first to be superficial, light, and un irritating. 
The common tepid water dressing, covered with a piece of oiled silk, 
is one of the best. Some use pledgets of simple ointment, poultices, 
and fomentations. These latter are generally employed during sup- 
puration ; but during the first two or three days, cold evaporating 
washes, and cold water, are best, when the wounded part is inflamed 
and hot, and the circulation is vigorous. 

Poisoned Wounds. 

To the bites of various creatures man is exposed in most climates, 
and all seasons of the year. These may be divided into three classes. 

Bites of Musquitoes and Spiders, and Stings of Bees and Wasps. — 

For these, the best applications are a solution of common salt, or 
water of ammonia, or sugar of lead (239), or laudanum, or tincture 
of iodine. If none of these are at hand, at the moment, cover the 
part with wet earth. Tincture of arnica (240) is a good application. 



SURGICAL DISEASES. 441 



Bites of Venomous Snakes. — Either instantly cut out a piece from 
the bitten part, or apply a dry cup, to prevent the absorption of the 
poison. Suction with the mouth will sometimes answer the same 
purpose. After doing one of these things, touch the part with caustic 
potash. Internally, give Fowler's solution, twenty drops, in a little 
water, every two hours. Also purgative injections, — stopping the 
arsenic when purging is well established. 

For the bite of the rattle-snake, the only known remedy is alcoholic 
drink, taken in large quantities, and immediately. Gin and whiskey 
are believed to be the best. Fill the system full. When the poison 
has begun to take effect, enormous quantities will be borne, before in- 
toxication can be induced. Keep the whole person saturated until 
the symptoms decline. 

Fractures. 

The existence of a fracture is to be known by the symptoms. 
These are, pain, swelling, deformity from the limb bending to one 
side, sometimes shortening of the limb, or loss of power to use it, and 
a crepitus or grating sound or sensation from the rubbing of the ends 
of the broken bone together. There are several kinds of fractures. 
They are 

The Transverse Fracture, which is directly across the bone. 

The Oblique Fracture, which runs from side to side, in an oblique 
direction. 

The Longitudinal Fracture, which runs lengthwise of the bone. 

A Simple Fracture is one in which the bone is broken simply, with- 
out any wound of the flesh with it. 

A Compound Fracture consists of a simple fracture, and of an ex- 
ternal wound in addition, caused by pushing the end of the broken 
bone through the flesh. 

A Complicated Fracture is one in which, beside the breaking of the 
bone, there is the dislocation of a joint, the wounding of an artery, 
the extensive tearing of the soft parts, or the wounding of the bowels 
or some other internal organ. 

A Comminuted Fracture is one in which the bone is broken into 
several pieces. ^ 

Treatment of Fractures. — When a bone is broken, the first thing 
to be done is to get the injured person to his home, or to the nearest 
house. To do this in a rough or careless way, might add much to 
his sufferings. 

K it be an arm which is broken, let it be placed in a broad sling, 
extending from the elbow to the fingers. In this condition the pa- 
tient, if in tolerable health, and the distance is not great, will find it 
easier to walk home, than to bear the jolting of a carriage. 

56 





442 SUllGia\X DISEASES. 

If the log or the thigh be broken, then a hurdle of some sort (Fig. 
148), must be obtained as soon as possible, and, being covered with 
straw, or blankets, or ^ar- ^ ,,„ 

, . , . , 1 ~ I 1 Fig. 148. 

ments, the patient should 
be gently lifted upon it by- 
just persons enough to raise 
him easily from the ground. 
This should now be carried 
by four persons, two at each end, moving with great gentleness, and 
keeping exact step with each other. If these persons take hold of 
the ends of two poles, laid under the hurdle, they will find they can 
carry it much more easily. If no hurdle be at hand, let four poles, two 
long ones, and two short ones, be laid across each other at right angles, 
and fastened together with nails or strings. Then lay upon these an 
old door, or some loose boards ; and the injured person may be easily 
carried upon this temporary structure. A blanket fastened upon four 
poles, in the manner of a cot-bed, will answer a good purpose. 

Having placed the patient upon the hand carriage, bring the sound 
limb and the broken one snug together, and tie them to each other 
with two or three pocket handkerchiefs ; this will support the broken 
limb, and prevent its being shaken about and injured by motion. In 
doing this, the limb should be laid as near as possible in the natural 
position, so that the bones may not get out of place, and their ends 
get pushed through the flesh. 

The Reduction, or Setting* of the Fracture, is the first thing to be 
done. By this is meant the bringing of the ends of the broken bone 
together, and adjusting them to each other in their natural position. 
This is done by what surgeons call extension^ counter-extension^ and 
coaptation. 

Extension means taking hold of the limb below the fracture and 
pulling from the body. 

Counter-Extension is pulling above the fracture towards the body. 
These opposite pullings are done at the same time to overcome the 
force of the muscles, which contract, and draw the ends of the bone 
by each other and shorten the limb. 

Sometimes no extension or counter-extension is necessary, the ends 
of the broken bone not being pulled out of their place. When the 
pulling is necessary, it should be gentle and steady. 

Coai)tation means adjusting the ends of the bone to each other. 

The next thing is to provide for keeping the ends of the broken 
bone steadily in contact, so that nature may have a fair chance to 
unite them. 

To secure this object, mechanical contrivances are used, which are 
simple, and may always be had without difliculty. 

They consist of linen bandages^ about the breadth of four fingers, 
and from four to ten yards long ; and pads^ made of old woollen cloth 
or blankets lightly quilted together, or pillow-cases filled with tow, or 
chaff, or cut straw, or even leaves ; and of splints^ made of clapboards, 



SURGICAL DISEASES. 



443 



or thick yhinglcs, four fingers wide, and in length corresponding with 
that of the broken limb; or wheat straw laid, side by side, and quilted 
into a piece of cloth to prevent them moving about. A very useful 
splint may be made from the fresh bark of trees. 

The pads are to be placed under the splints, to prevent injuries to 
the skin ; and the bandages to be bound over the whole. 

For some hours after a limb is broken, the parts continue to swell ; 
and if bound up immediately with the pads, splints, etc., much need- 
less pain will be occasioned. It is best, therefore, not to put these on 
under two or three days, but merely to lay the limb in a natural 
position, and perhaps lightly bind one splint to it. Broken ribs and 
collar bones are exceptions, and should be bound up immediately. 

A broken arm lies easiest half bent, upon a pillo\y ; the thigh or 
leg, upon the outside, with the knee bent. 

When the apparatus is once adjusted, the less it is meddled with 
the better. 

In fractures of the shoulder or arm, a sling is a contrivance of great 
importance. This, if well made and adjusted, keeps the broken bone 
in its place, and at the same time, allows the patient to take some 
exercise by walking about. 

Fio. 149. 




Beside the above contrivances, there is the double inclined plain 
(Fig. 149) for giving the leg the advantage of a bent position. There 



Fig. 150. 




are also fracture-boxes (Fig. 150), B,nd fracture-cradle s^ — the latter to 
keep the bed-clothes lifted away from the painful limb. Fracture- 



444 SURGICAL DISEASES. 



beds are now brought to great perfection, and one j^hould, if possible, 
be procured when the patient is likely to be confined a long time 
with a compound fracture. The fracture-box, represented by Fig. 
150, may be made from thin boards, by any carpenter. It has a 
hinge at the knee to enable it to fulfil the double purpose of a double- 
inclined plane and a fracture-box. 

The Way in which Broken Bones Unite. 

The union of broken bones is much slower than that of severed 
flesh. The ends of the bone being kept steadily together, they soon 
become surrounded by a swelling of the soft parts, which change to 
a sort of osseous substance, making a kind of bony hoop, to act as a 
splint or support, — nature not being willing to trust the surgeon to 
keep the fragments axactly in their place. This is called a provis- 
iofial callus, because it only has a temporary use. 

This First Sta^e lasts about ten days. At the end of this time, a 
spongy substance appears between the ends of the bone. This sub- 
stance is not bone, but in the swelling around the fracture specks of 
bone begin to be deposited ; the fibrine here poured out becoming 
first cartilage, and then receiving into itself phosphate of lime, it be- 
comes bone. A similar work is going on within, in the part called 
the medullary membrane. 

This Second Stage lasts from the tenth to the twenty-fifth day. 

Then Begins the Third Stage, which goes to the end of the sixth 
or eighth week. During this period, the external swelling, and the 
internal medullary membrane, become completely ossified and firm ; 
though the ends of the bone are not yet grown together. 

The Fourth Stage goes to the end of the fifth or sixth month. 
During this time, the external swelling, or provisional callus, becomes 
covered with ^periosteum, and the ends of the bones themselves are 
fastened together by a bony union. 

The Fifth Stage extends from the fifth or sixth to the tAvelfth 
month. During this time, the ends of the bone become grown to- 
gether so strongly that the bony ring, or provisional callus, is no 
longer wanted, and it becomes absorbed, and disappears, — in other 
words, having no further use for it, nature takes off her splint. The 
place where the fracture was, is now as strong as any other part. 

Union in Compound Fractures. 

The union of compound fractures takes place in a different way 
from that of the simple fracture, just described. In this case there is 
suppuration, and the bones remain disunited several weeks, and there 
is no provisional callus formed. But after some weeks, the ends of 
the bone soften and granulate ; and when the production of pus de- 
clines, these granulations are gradually changed into bone. 



SURGICAL DISEASES. 445 



Time Required for Uniting Different Bones. 

Fractures of the arms unite sooner than those of the legs. 

The ribs and collar bone unite with tolerable firmness in about a 
month ; those of the arm in six weeks ; of the thigh and leg in eight 
weeks. I only mean the firmness derived from the provisional callus. 

A broken bone will unite much sooner in a healthy person than in 
an unhealthy one ; much sooner in a young than in an old person. 

As a general rule, the apparatus should be kept on thirty days in 
the case of children ; forty days in that of adults ; and much longer 
in that of aged persons. 

False Joint. 

The union of a broken bone is sometimes prevented by a frequent 
moving of the limb. The ends of the bone having failed to grow to- 
gether, will sometimes become rounded and smoothed, uniting only 
by a kind of ligament, and acquire the habit of sliding upon each 
other, and thus form what is called ^ false or artificial joints — the 
limb being permanently capable of bending, to some extent, at the 
place of the fracture. 

Fractures of the Skull. 

These are always dangerous in their nature, and the aid to be 
derived from surgery much less than in other fractures. If a fracture 
of the skull produce deep sleep, and snoring, and the patient does 
not show any symptoms of pain when pinched, etc., we are to infer 
that a piece of bone is pressed down upon or into the brain. 

In this case, if the position of the blow be known, a cut is to be 
made through the skin, two or three inches long, down to the bone. 
If arteries bleed, they must be taken hold of with a pair of forceps, 
and tied with a silk thread, the ends of which are to be cut off. The 
bone being well exposed by one or two incisions, the piece which is 
pressed down upon the brain is to be raised with a chisel, or some 
similar instrument, to a level with the other bones. The surface 
must then be cleaned with a sponge, the hair around shaved off, the 
skin brought together, and the cut edges reunited by sticking plaster. 

When the inflammation appears, twenty-four hours after, it is to be 
kept down by doses of from five to ten drops of tincture of veratrum 
viride, given every one or two hours. 

Fractures of the Bones of the Nose. 

Injuries of this kind may generally be rectified by passing a strong 
probe up the nostril, and pressing out the bones to their natural place, 
at the same time using the fingers on the outside to prevent their 
being pressed out too far. Inflammation must be kept down by 
cloths wet in cold water and laid on, and by light diet. 



446 



SURGICAL DISEASES. 



Fig. 151. 



Fra,cture of the Lower Jaw. 

This usually takes place near the chin. It may occur also near the 
angles of the jaw. It may be simple or compound, and is known by 
the pain, the swelling, the inability to move the jaw, the indentation 
felt by the finger, the irregularity of the teeth, and the grating sensa- 
tion felt while moving the jaw with the hand placed on the back 
fragment. 

Treatment. — Let one or both thumbs be introduced into the mouth. 
With these, keep the back part of the jaw stationary, and pull for- 
ward the fore part with the fingers on the 
outside. In this way the fracture can 
soon be put right. This done, shut the 
mouth firmly, and place a thick compress 
of lint over the broken part ; over this put 
a piece of pasteboard, wetted so as to 
bend easily to the parts, and over this a 
strong bandage of muslin, two and a half 
inches wide, with a small bag to fit and 
hold the chin ; all which is represented in 
Fig. 151. 

For a fortnight the patient must feed on gruel, broth, arrow-root, 
and milk, that the jaw may not be displaced by chewing. 




Fracture of the Collar Bone, or Clavicle. 

This accident generally occurs about the middle of the bone, and 
is generally caused by falls on the arm and shoulder. 



Fig. 152. 



Fig. 1:3. 





Sjiiiptoms. — Pain and tenderness at the place of the injury, and 
inability to lift the arm ; a small bunch or prominence at the point of 



SURGICAL DISEASES. 447 



the fracture ; the distance from the point of the shoulder to the breast- 
bone shorter than on the other side ; and the dropping downwards, 
forwa-Fiis, and inwards of the shoulder. To make the case sure, com- 
pare the two bones, and see whether they agree. 

Treatment, — Place the knee between the shoulder-blades, and 
grasping the round ends of the shoulders with the two hands, draw 
them gently back till the ends of the bone come to their proper place ; 
or, place the elbow of the patient close to the body, and a little for- 
ward, and then push it upward. 

To retain the shoulders in this upward and backward position for 
some weeks, pass a flannel bandage, four inches wide, around the 
front of one shoulder, under the arm-pit, across the back, over the 
opposite shoulder, under the other arm-pit, and again across the back, 
in the form of the figure oo. To prevent the bandage frOm cutting 
the skin, put pads under the arms. (Figs. 152 and 153.) 

Fracture of the Shoulder-Blade. 

Whex this accident happens, the body of the bone is generally 
broken across by some great direct violence. In a few instances, the 
end next to the collar-bone is broken. 

Symptoms. — Great pain in moving the shoulder, and the grating- 
sensation which may be felt by placing one hand on the upper end 
of the bone, and moving the lower portion with the other. 

Treatment. — A bandage must be passed round the chest, and a 
few turns be made around the upper arm, so as to fasten it to the 
side, and prevent all motion. Purging, low diet, and the tincture of 
veratrum viride will be required to keep down inflammation. 

Fracture of the Acromion, or the end of the scapula which unites 
with the collar-bone, may be known by the flattening of the shoulder, 
— the broken part being drawn down by the action of the deltoid 
muscle. 

Treatment. — It must be supported by the same bandages as are 
used for a fracture of the collar-bone ; and the elbow must be well 
raised, so that the head of the upper-arm bone may be lifted against 
the upper portion of the scapula, and act as a prop to keep it in place. 
No pad should be put in the arm-pit, for this would push the broken 
part too much outward. 

Fracture of the Upper-Arm Bone. 

The bone of the upper-arm is most frequently broken near the 
centre, though it may be fractured near the ends. It may be known 
by taking hold of the arm above and below the suspected fracture, 
and attempting to move the ends of the upper and lower fragments 
upon each other. If there be a fracture, the grating of the broken 
ends against each other will either be heard or felt. The arm will 



448 SURGICAL DISEASES. 




also be bent and helpless ; and if the ends of the bone be slipped by- 
each other, it will be shortened. 

Treatment. — Let a powerful man take hold of the arm and pull 
gently and gradually, but with considerable force, till the arm is 
brought to its natural length, — another man taking hold of the body 
of the patient, and pulling in an opposite direction. In the mean 
time, the surgeon is to adjust the ends of the bone to each other, 
and apply a bandage, but not very tightly, from the elbow to the 
shoulder, and over this, four splints, with pads under them ; one in 
front, reaching from the shoulder to the bend of 
the elbow, with a few turns of the bandage over ^^^" ^^' 

it ; another behind, reaching from the shoulder 
to the point of the elbow, with a few turns of the 
bandage around it, also ; another on the inside, 
extending from the arm-pit to the inner projection 
of the bone at the elbow, also secured by a few 
turns of the bandage ; and the fourth one on the 
outside, reaching from the shoulder to the outside 
knob at the elbow. The whole is now to be se- 
cured either by a bandage or tape. (Fig. 154.) 
The arm is to be confined to the side, and the hand and fore-arm 
placed in a sling. In from seven to ten days, the dressing should be 
taken off to see if all is right. 

Fracture of the Elbow. 

This may be known by the patient being able to bend the arm, but 
not straighten it, and by the grating which may be heard or felt when 
the arm is moved back and forth by the operator, and also by the 
severe pain felt in the fractured part. 

Treatnieiit, — First apply leeches and evaporating lotions to reduce 
the inflammation. When this is effected, straighten the limb, and ap- 
ply a bandage snugly from the fingers to the elbow. The broken 
end of the bone must now be brought to its place, and the bandage 
continued over it, and for a few inches above it. Secure it here, and 
bring it back, — carrying it above and below the elbow for several 
times ; and then extend it up to the shoulder. A splint must now be 
applied to the inner side of the arm to prevent its being bent, —ex- 
tending from the hand nearly to the shoulder, and another, of similar 
shape, to the outside. The joint should be kept quiet for four or five 
weeks, — during which time, the splints may be taken off three or 
four times, to see if there is any chafing of the skin, or any disturb- 
ance of the bones. 

Fractures Between the Elbow and Wrist. 

The part of the arm between the elbow and wrist, called the fore- 
arm, has two bones, — one extending from the elbow on the inside to 
the wrist at the root of the little finger, called the ulna, and the other. 



SURGICAL DISEASES. 449 



on the side next the thumb, a shorter and a smaller bone, and called 
the radius. 

When both these bones are broken at the same time, the fracture 
may be easily discovered ; when only one, the sound bone keeps the 
other in place, and the injury is not so easily made out. 

Treatment. — Relax the muscles by bending the elbow, and then, 
by extension and counter-extension, put the ends of the bones in 
proper place, and then place two splints thickly padded in the centre, 
one upon the front of the hand and fore-arm, and the other upon the 
back of the hand and fore-arm, — the palm of the hand being turned, 
not towards the chest, but downwards. They are to be covered with 
a bandage from the fingers to the elbow. The whole arm and hand 
should be placed in a sling, and remain in this position four or five 
weeks. 

Fractures of the Wrist, Hands, and Fingers. 

The setting of fractured bones in these parts is to be done by ex- 
tension and counter-extension, as in the case of other bones. 

If the wrist be broken, a splint should be applied in front and one 
behind, and a bandage bound tightly from the hand half way to the 
elbow. 

In fracture of the bones of the hand, a pad or compress must be 
put upon the palm of the hand, and a splint placed over this, with 
a bandage extending from the wrist to near the ends of the fin- 
gers. 

If one finger only be broken, apply narrow paste-board splints on 
four sides, and cover them with a narrow bandage ; and then bandage 
the whole hand. 

In all these fractures, place the hand in a sling. About three weeks 
will be required for the bones to unite properly, and several weeks for 
the parts to acquire their natural usefulness. 

Fracture of the Ribs. 

This accident occurs either by blow^s, or by being crushed between 
two opposing forces. One, two, or more ribs may be broken at a 
time, according to circumstances. 

Symptoms, — A fixed, piercing pain, made worse by breathing, 
coughing, or any other motion, and also a grating sensation during 
the taking of a long breath, the hand being laid upon the injured part 
at the time. 

Treatment. — The ribs are to be held steadily in their place by pres- 
sure. To effect this, request the patient lo draw in a long breath, 
and hold it. While the ribs are swelled out in this way, and the 
broken ends are thus brought to their proper place, pass a woollen 
bandage, five or six inches wide, several times tightly around the 
chest, from the arm-pits to the pit of the stomach. This will confine 

57 



450 SURGICAL DISEASES. 



the muscles of the chest, and the breathing will have to be done with 
the muscles of the belly, and the ribs will thus be kept still, and 
have a chance to grow together. 

If the pleura be wounded, and inflammation follow from this or 
other cause, the patient must be confined in bed, kept on a low diet, 
and his pulse be kept down by tincture of veratrum viride. The 
bowels should be emptied by recipes 18, or 20, or 27, or 41, both to 
subdue inflammation, and to give the diaphragm a chance to drop 
down freely. 

Fracture of the Breast-Bone. 

Symptoms. — The injured part is frequently either sunk down or 
raised up ; there is difficult breathing, cough, spitting of blood, pain, 
inability to lie on the back, and a grating noise caused by breathing. 

Treatment. — The same as that for broken ribs. Should the broken 
part be pressed down upon the lung, so as to cause serious difficulty 
of breathing, an incision may be made, and the broken piece raised 
up with a chisel, or stiff case knife, or some similar instrument. 

Fracture of the Haunch Bones, or Pelvis. 

These fractures are dangerous, — being often connected with some 
other injury, as tearing of the bladder, lower bowel, or great veins or 
arteries. Fortunately, however, they are only caused by some great 
violence, and do not often occur. 

Treatment. — Place the patient in the easiest possible position, and 
keep him entirely at rest. Generally a catheter should be kept in the 
bladder, that the water may pass off* easily ; and the whole hips 
should be bound round tightly with a flannel or calico bandage, and 
made as firm and fixed as possible, to keep the broken bones together. 
The most perfect rest must be ordered for six weeks or two months. 

If the extreme lower end of the sacrum, the os coccygis (Figs. 8 — 3) 
be broken, the separated portion must be put in its place by introduc- 
ing the finger into the rectum ; and the bowels must be kept loose by 
gentle physic, that the broken bone may not be pushed from its place 
by the pressure against it of hard stools. 

Fracture of the Thigh-Bone. 

The points where this bone are broken are at its upper portion or 
neck, and near its middle. The break at this latter place may be 
straight across, or oblique, — partially lengthwise. When oblique, the 
point of the bone may stick into one of the large muscles, and be 
made fast by it. 

Symptoms, — The fracture in the middle of the bone, if it be trans- 
verse, may be known by some swelling or irregularity discovered by 
running the hand along the thigh, and grasping it here and there ; 



SURGICAL DISEASES. 



451 



and if it be oblique, the ends of the bone will be drawn by each 
other, and the limb will be shortened. 

Treatment, — Place the patient on his back, and let two strong men 
use extension, — one taking hold near the hip, and the other grasping 
the limb at the knee and pulling steadily and strongly till the limb is 
of the proper length, and the ends of the bone are in their place. The 
man who takes hold of the upper end of the limb may hold it more 
iirmly and with less fatigue by passing a folded sheet around the groin. 

The extending force being still continued, the operator is now to 
apply the splints, which are to be four in number, — one in front, 
reaching from the knee-pan to the groin ; one behind ; one on the 
inside, from the upper part of the thigh to the inside of the knee ; 
and a fourth one, about four inches wide, reaching from the arm-pit 
to a distance of two or three inches beyond the sole of the foot. 
Cotton must be placed under these splints to prevent their injuring 
the skin, and they must be of a width to nearly, but not quite, touch 
each other. These being properly adjusted, and' the extension still 
continued if the fracture is oblique, the bandage is now to be firmly 
applied from the foot to the upper part of the thigh, and then passed 
a few times around the body. This fracture is sometimes treated 
without splints, as represented in Fig. 155. 



Fig. 155. 



Fio 156 





Six or seven weeks will be required for the bones to grow together, 
during which time the patient will need to lie upon his back. But 
the dressing may now and then be taken off and put on again. 



452 SURGICAL DISEASES. 



Sometimes only a single long splint is used ; sometimes no splint ; 
in still other cases, four splints, — the outside one being short, and the 
limb resting on a double inclined plain. 

Fracture at the ^'eck of the Bone. — When the bone is broken at 
the neck, close to the hip joint, the injury is known by the knee and 
foot turning outward^ and by the limb being an inch or two shorter 
than the other (Fig. 156). This is an accident to which old persons 
are particularly liable. When the bone is broken here, it seldom 
grows together again. The union which is formed is generally by a 
ligament. 

Treatment. — This requires a very long splint, reaching from the 
armpit to beyond the sole of the foot, and bound firmly with a band- 
age, as in fracture in the middle of the thigh. The limb should be 
kept extended, and the injured one must be bound to the other by a 
bandage, keeping both legs straight and immovable. A broad leather 
strap, bound firmly round the hips and thighs, will be serviceable. 

Two or three months will be required for the injury to become 
repaired, so that the limb may be used. The patient must get up 
cautiously, and be careful not to use the limb much so long as pain 
is produced. 

Fracture of the Knee-Pan. 

The knee-pan (patella) may be broken up and down, or across ; — 
1he latter fracture is the more common. It is a troublesome fracture, 
and is very apt to leave a stiff knee. 

Symptoms. — When the bone is broken across, the patient cannot 
stand upon the limb ; the leg may be flexed or crooked, but cannot 
be straightened ; the upper part of the knee-pan is drawn up away 
from the lower portion, leaving a wide gap, into which the fingers 
may be laid, — at the top and bottom of which the rough edges of 
the movable bones may be felt. 

Treatment. — First, reduce the inflammation by tincture of arnica, 
leeches, etc. Then straighten the limb, and put a well-padded splint 
behind, to keep the knee motionless ; place the patient's body in a 
half-sitting posture, and raise the foot considerably above a level. 
Put a bandage over the splint, beginning half way up the thigh, and 
extending down to the knee-pan, and being made very tight just 
above the broken bone, so that it cannot easily slip under it. The 
broken bones must now be brought together, and the bandage be 
passed below and again above the knee several times in the form of 
a figure 8, to keep the bones from parting. 

The bandage, generally, may not be removed for a fortnight. After 
this period, if everything has gone on well, the limb may be carefully 
bent a little every day, to avoid a stifl* knee. 



SURGICAL DISEASES. 45 




Fracture of the Leg. 

The leg: is that part of the limb between the knee and ankle. It 
has two bones; the smaller on the outside, called the Jibula ; the 
larger on the inner and front side, called the tibia^ or shin bone. 

One or both of these may be broken at the same time. If both 
are broken, it is impossible to walk upon the limb ; there is a change 
in its shape ; it may be bent ; and the grating of the broken ends of 
bone may be felt or heard. 

Treatment. — First, adjust the bones by means of extension and 
counter-extension, as in other fractures. Then apply two splints, one 

on the outside from the knee to the sole 
of the foot; the other upon the inside. 
Over these a bandage is to be firmly ap- 
plied, reaching from the toes to the knee. 
The leg may rest upon the side or the 
back, as the comfort of the patient may 
require. Upon the side is generally the 
easiest position, with the knee a little 
bent (Fig. 157). 

The dressing may be removed in six or 
seven days, to see that the bones are in their proper place. Five or 
six weeks will be required for recovery ; and at the end of this time, 
the dressing may be laid aside. But the patient must use his leg 
very gradually. 

One of the simplest methods of treating a fractured leg is to place 
it in a fracture-box. A pillow is to be placed in this, and the leg, the 
bones being put in place, is to be placed in the box, and the foot to 
be secured to the foot-board by a bandage, and the sides of the box, 
movable upon hinges, are to be brought close enough to the limb to 
keep the bones in place, — compresses, etc., being placed around the 
limb as required. Bran may be placed in the box in place of a 
pillow. 

Fractures of the Bones of the Foot. 

These are to be treated in the same manner with fractures of the 
hand. They are often attended with much other mischief, as lacera- 
tion of the flesh, ligaments, etc. Hence, cutting oif the foot, or a 
part of it, is often necessary. Paste-board splints are frequently used 
in these fractures. If matter forms, it must be let out by opening the 
parts. 

Compound Fractures. 

WriEN, in connection with a broken bone, there is a wound of the 
flesh, which leads to, and communicates with the space between the 
broken ends of the bone, the whole injury is called a compound frac- 



454 SURGICAL DISEASES. 



tnre. The wound in the flesh may be caused by the same force 
which breaks the bone, as a bullet from a gun, or a cart-wheel, or 
some machinery in which the limb is entangled. Quite often the 
flesh wound is caused by one of the ends of the bone being forced 
through the flesh and skin. 

But, however caused, a compound fracture is of a much more 
serious nature than a simple one ; and it is particularly dangerous 
when a joint is involved. It is more serious above the knee and 
elbow than below, and more to be dreaded in the lower limbs than 
in the upper. 

Treatment. — An attempt should generally be made to preserve 
the limb ; it should not be cut off", unless the compound fracture is of 
the worst kind. But if there be no hope of saving the limb, the 
amputation should be performed at once, while the constitution is 
tranquil, and before it has been shocked and injured by the sympa- 
thetic fever, suppuration, abscesses, and hectic, which are almost sure 
to follow such grave injuries. 

But, suppose it be determined not to cut the limb ofl", — as it gen- 
erally should be, — the first thing is, after the bone is set, to close the 
wound against all entrance of air, and to cause it to heal by the first 
intention, that is, without suppuration. To do this, one method is to 
cover the wound with lint dipped in blood ; but the more usual mode 
is, to bring the sides of the wound together, and secure them very 
carefully by strips of adhesive plaster, in the same way as in common 
cuts. The bandage should be kept wet with cold water, by squeez- 
ing a sponge over it, or by sprinkling cold water upon it as fast as it 
becomes dry. • 

It will be necessary, in this case, to keep the bed-clothes away from 
the limb while it is thus wet, which may be done by cutting a barrel 
hoop in two, and nailing it to two pieces of lath. There should be 
air circulating under the sheet, that the heat of the inflammation may 
not keep the limb in a steam-bath. 

Should the wound heal by the first intention, the danger will soon 
be over, and the treatment may be the same as for simple fracture. 
But this, unfortunately, does not often occur. 

It more often happens, that after three or four days, the patient 
grows restless, has very short and disturbed sleep, is hot and thirsty, 
has headache and shivering fits, is more ill towards evening, wanders 
in his mind, or becomes delirious, and perhaps dies in ten days or a 
fortnight from these constitutional disturbances. If the symptoms 
are a little less severe, the wound will at first discharge a small quan- 
tity of dirty, bloody matter, which, if everything goes well, will, by 
degrees, change to healthy matter, without smell, of a straw color, 
and about as thick as cream. 

The fever, and other bad symptoms, will now subside ; the sleep 
and appetite come back, and a new process begins, that of healing by 
granulation, or the formation of new flesh to fill up the gap made by 
the wound. 

For old persons, or those whose health has been broken, this stage 



SURGICAL DISEASES. 455 



is full of danger, and is apt to result in death, if the lower limb be 
the injured part. 

If the constitution proves unable to bear up against this stage of 
the injury, alternate heat and sweating set in, the face is flushed with 
a pink color, the pulse becomes weak and quick, the body wastes, the 
appetite disappears, the tongue becomes dry and brown, restlessness, 
wandering, and delirium, follow in quick succession, and all are 
speedily terminated by death. With the setting in of these symp- 
toms, the wound stops discharging, or throws out only a thin, watery 
and stinking matter. Quite often the skin and other parts mortify, 
and if there be strength enough to throw off the dead parts, the 
broken ends of the bone stick out, looking dead and white. 

When the constitutional symptoms begin, apply poultices, to set 
up, if possible, the formation of good matter ; for if this can be 
brought about, the symptoms may be regarded as favorable. The 
poultice must be continued till the wound is filled with new flesh 
nearly to the surface. 

In the First Stage, the medical treatment must have reference to 
checking the inflammatory condition. This may be done by full 
doses of tincture of veratrum viride. Should the symptoms take a 
typhoid type, and the powers of life seem to sink, then quinine, and 
iron, and bitters will be needed. 

In the Second Stage, whatever inflammation there is depends on 
exhaustion, and everything fitted to prop and fortify the constitution, 
as brandy, wine, broth, and easily digested, nourishing food, must be 
freely given. 

Dislocations.— Luxations. 

The surfaces where two bones meet and glide upon each other for 
the purposes of a joint, are called articular surfaces^ and the union is 
said to be an articulation. These surfaces are covered by a smooth 
cartilage, to render their play upon each other easy. 

The joints are held together by cartilaginous straps and ligaments, 
which serve as pullies ; by the aid of these, the joints turn back and 
forth, as a door opens and shuts upon its hinges. 

When by some external violence, or the weakening of these liga- 
ments, these surfaces- are suddenly separated, or forced apart, there is 
said to be dislocation or luxation. 

Joints are divided into two kinds, the ball and socket (orbicular) 
which has a rotatory motion, as the shoulder, hip, thumb, — and the 
angular, or pump-handle (ginglymoid), as the elbow and knee. 

The ball and socket joints have a greater diversity of motion, and 
are more exposed to dislocation. They are likewise more easily put 
in their place. 

In a Primary Dislocation, the bone is thrown at once into the place 
where the surgeon finds it. 

The Secondarj^ Dislocation is one in which the muscles pull the 



456 SURGICAL DISEASES. 



head of the bone still further from its natural place than it was 
thrown by the first shock of violence. 

A Dislocation is Simple when there is no wound penetrating the 
synovial membrane. 

It is Compound when attended by such a wound. 

A Dislocation is Complete when the articular surfaces are entirely 
separated. 

It is Incomplete when the separation is only partial. 

Recent Dislocations are rectified with comparative ease. 

01(1 Dislocations are hard to be repaired, and sometimes cannot be 
reduced at all. 

The Symptoms of Dislocation are, inability to use the joint; the 
head of the bone being felt in an unnatural place; the limb shortened, 
lengthened, or distorted ; a change in the shape of the joint, etc. 

Simple dislocations are generally trivial. Compound dislocations 
often render amputation necessary, and are always perilous. 

Aged persons are less liable to dislocations than the young. 

When a dislocation and a fracture occur at the same time, the dis- 
location is to receive attention first. 

A dislocation is to be reduced by a gradual and continuous extend- 
ing force. The reduction is known by the Jimb recovering its natural 
length, shape and direction, and by its being able to perform certain 
motions which are not possible while in a dislocated state. The pain 
is immediately reduced upon reduction taking place. In shoulder 
and hip dislocations, the head of the bone makes a loud noise when 
it slips into its place. 

Dislocation of the Lower Jaw. 

Gaping very wide is the usual cause of this. It has been known 
to result from a mere yawn. One or both sides may be disjointed. 

Symptoms. — If but one side is dislocated, the chin is twisted to one 
side, and immovable, and the jaws are partially open; if both sides, 
the mouth is wide open, the chin projects, there is a hollow in front 
of each ear, great pain, inability to speak, and dribbling of spittle 
from the mouth. 

Treatment. — To effect a reduction, cover the thumbs with a towel 
or a piece of wash-leather to prevent their being injured by a sudden 
snapping together of the jaws, and then, standing in front of the 
patient, introduce them into the mouth, press them upon the crown 
of the back lower teeth, at the same time lifting the chin with the 
fingers. 

After the jaw is set, it should be kept bandaged for a few days, — 
the bandage being merely passed once or twice over the top of the 
head, and under the chin. No solid food requiring chewing should 
be taken for a short time. 



SURGICAL DISEASES. 



457 



Dislocation of the Collar-Bone. 

This may take place by the end attached to the breast-bone slip- 
ping over or under that bone, or by the other end slipping above or 
below the bone to which it is attached. When the first named end 
of the bone slips oi^er the breast-bone, it is said to be ?i forward dis- 
location ; when it slips wider the breast-bone, it is backwards In this 
latter form of dislocation, the end of the collar-bone sometimes presses 
upon the gullet, and prevents swallowing. 

Symptoms. — In the forward dislocation of the inner end of the 
bone, a bunch may be felt by the hand at the top of the breast-bone ; 
in the backward dislocation^ a depression or holloiv. The upward dis- 
location of the outer end of the collar-bone, may be known by the 
flattened and sunken condition of the shoulder. 

Treatment. — To put the bone in its place in the first of these ac- 
cidents, draw the shoulders back, by which means the collar-bone 
(clavicle) is drawn away from the breast bone (sternum), and easily 
slips into its place. To reduce the dislocation at the other end of the 
bone, place the knee between the patient's shoulder-blades (scapulEe), 
and draw his shoulders backwards and upwards. After the reduction, 
support the arm in a sling. 

Dislocation of the Shoulder-Joint. 

The head of the long bone of the arm (humerus) may be displaced 
in three different directions, — doivnward^ into the arm-pit (axilla); 
forward^ under the muscles of the breast ; and backward^ upon the 
back of the shoulder-blade. 

rio.158. 




It is recognized by the shoulder losing its roundness, and becoming 
fiat ; by the lengthening of the arm ; by the head of the bone being 
felt in the arm-pit ; and by severe pain. " 

58 



458 SURGICAL DISEASES. 



To effect the reduction in the first form of displacement, put the 
patient on a bed, or upon the floor. Put one heel in the arm-pit, 
against the head of the bone. Then, taking hold of the arm above 
the elbow, or at the wrist, pull steadily, and push with the heel. 
(Fig. 158.) The extension may be more steady and powerful by a 
double towel around the surgeon's neck. 

If the reduction cannot be effected, relax the muscles by a warm 
bath, or by nauseating doses of tartar emetic. 

After the reduction, a sling will be required, and three weeks' or a 
month's rest. 

Dislocations of the Elbow Joint. 

Of these there are six varieties. In the first, both bones of the 
fore-arm (radius and ulna) are thrown backwards ; in the second, both 
are drawn backwards and inwards ; in the third, both are thrown 
backivards and ontivards ; in the fourth, the ulna alone is forced back- 
wards ; in the fifth, the radius is forced forwards ; and in the sixth, 
the radius is throwyi backwards. 

In general, these dislocations are all easily set. In the first four, 
the knee is to be placed at the bend of the elbow, and the fore-arm 
bent upon it, the surgeon grasping the upper arm with one hand, 
and the fore-arm with the other. In the dislocations of the radius, 
the upper arm is to be put in a fixed condition, while the surgeon 
takes hold of the hand and pulls, at the same time throwing the bone 
forward. If the luxation be backwards, there must be the same ex- 
tension and counter-extension, while the fore-arm is bent. 

Treatment. — The fore-arm must be placed in a half-bent position, 
and a splint should be bandaged upon the front of the whole limb, 
compresses being placed upon the head of the bones opposite the 
direction of the dislocation. This confinement must be continued 
three weeks. 

Dislocations of the Wrist. 

• 

These are caused by falls upon the hand. Both the radius and 

ulna may be thrown backwards or forwaj'ds upon the wrist, caus- 

j.j^ ^gg ing a projection either in 

front or behind. (Fig. 
159.) The bones are to 
be set by pulling in 
opposite directions upon 
the hand and the fore- 
arm, and pressing later- 
ally, if the displacement be at the side of the wrist. 

Treatment, — Put a straight splint on the front, and another on the 
back of the fore-arm and hand, with compresses on both sides of the 
wrist, and a bandage over the whole. Support the fore-arm in a sling, 
and keep down inflammation by cold water, cooling lotions, etc. 




SURGICAL DISEASES. 



459 



Dislocations of the Bones of the Hand. 

Some one of the carpel bones may be pushed np out of its place, 
so as to (orm a projection on the back of the hand. To put it in its 
place, press upon it simply, and then put compresses on the front and 
back, with straight splints upon these and a bandage over all. Put 
the hand in a sling. 

Dislocations of the finger joints may generally be replaced by bend- 
ing the displaced phalanx over the head of the bone from which it 
has been disjoined. Sometimes a good deal of extension and counter- 
extension are required, for which purpose a piece of cord may be 
wound around the finger, — the skin being protected by covering it 
with a piece of wetted buck-skin. 

Dislocations of the Hip-Joint. 

These are four in number, — vpwards^ downwards^ hackvmrds and 
tipirards, fonrards and vpioards. 

To reduce these, a greater amount of power is needed than in the 
dislocations of any other bone, — owing to the greater power of the 
muscles which are to be overcome. 



Fig. IGO. 



Fia. 161. 





Dislocations of this joint are often confounded with fracture of the 

This latter may be distinguished 



head and neck of the thigh bone. 



460 



SURGICAL DISEASES. 



from the luxation by the grating sound to be heard, by the possibility 
of pulling the limb out to its natural length, and by its being short- 
ened up again by the action of the muscles the moment the pulling 
is given up. 

The Upward Dislocation of the head of this bone upon the back of 
the haunch bone, is known by the shortening of the limb, and by the 
knee and foot turning' inward^ — the foot lapping over the opposite 
foot, and the great toe resting upon the other instep. (Fig. 160.) 

The Dislocation Downward is known by the lengthening of the 
limb, the projection of the knee, the turning of the foot and knee out- 
ward^ and the bending of the body forward. (Fig. 161.) 

The Dislocation Backward and Upward is distinguished by the 
inclining of the foot and knee inward, the drawing up of the heel, 
and the resting of the great toe against the bail of the great toe of 
the other foot. (Fig. 162.) 



Fig. 162. 



Fio. 163. 





The Dislocation Upward and Forward is known by the shorteninc^f 
of the limb, and the turning of the foot and knee outward. (Fiir. 
163.) ^ " 

For replacing the bone, put the patient upon a table, on his back. 
Draw a sheet between his thighs, and, extending it up by the side of 
his body, let it be fastened to a staple. Put a padded belt, with rings 



SURGICAL DISEASES 461 



attached, around the injured limb, just above the knee. To these 
rings, fasten one block of a pulley, and attach the other to a post, 
giving the pulley-rope to an assistant. The surgeon now standing 
on the injured side, directs gradual extension to be made, while he, 
by his hands, or by a band passing around the injured thigh and over 
his own shoulders, lifts the head of the bone, and guides it into its 
socket. 

Treatment. — Keep the patient in bed for two weeks or more, with 
his knees tied together by a strip of muslin, and a broad belt around 
his hips. 

Dislocations of the Knee-Pan or Patella. 

This bone may be thrown outward^ causing a great projection on 
the outside, and an inability to bend the knee. 

It may be thrown inward, causing the same impossibility to bend 
the knee, and a projection on the inside. 

To restore the bone to its place, put the heel of the patient upon 
the shoulder of an assistant ; then press down the edge of the knee- 
pan which is farthest from the centre of the joint, thus tilting up the 
other edge of the bone, when the muscles, aided by a lateral pressure, 
will draw it to its place. 

Treatment, — Put a straight splint upon the back of the limb, and 
make moderate pressure upon the knee by a bandage. Cold water, 
or cooling washes, should generally be applied. Keep the patient in 
bed two weeks. 



Dislocations of the Knee-Joint. 

There are four of these, — forward, backward, inward, and out- 
luard. 

They are readily corrected by extension and counter-extension from 
the ankle and thigh, and pressure upon the head of the displaced 
bone. 

Treatment much the same as for displacement of the knee-pan. 

Dislocations of the Ankle. 

These may occur in a forward, backward, outward, and inward 
direction. (Figs. 164 and 165.) 

To rectify it, bend the limb, so as to relax the muscles on the back 
of the leg ; then, while extension and counter-extension are made 
upon the foot and thigh, press firmly on the dislocated bone, and thus 
force it to its place. 

Treatment. — Confine the foot and leg in splints made of thick 
paste-board, soaked in hot water, and moulded to the shape of the 
limb, with a foot-piece at right angles. Keep the patient in bed five 



462 



SURGICAL DISEASES. 



or six weeks, and when he begins to walk, support the ankle with a 
roller bandage, or a laced gaiter. 



Fi».164. 




FiQ. 165. 




Contusions.— Bruises. 

When any blunt, hard substance comes in violent collision with 
the soft parts of the body, without breaking the skin, the injury 
received is called a bruise. One of these accidents generally rup- 
tures a great number of the very smallest blood-vessels, which let 
out blood under the skin, producing " black and blue^'' or livid spots 
(ecchymosis). "V^hdit fist-fighters call a black eye is an example. 

Treatment. — Cold applications at first to prevent the blood run- 
ning out of the small vessels under the skin. After the inflammation 
has subsided, stimulating applications, as vinegar and water, alcohol, 
camphorated liniment, ammonias and alcohol, equal parts, and some- 
times bandages. 

Sprains. 

A SPRAIN is a forcible wrenching and twisting of a joint to such a 
degree as to stretch and more or less lacerate the ligaments of the 
part, and sometimes to break a tendon, but without entirely displac- 
ing a bone. Its symptoms are, violent pain, swelling, and discolora- 
tion of the parts from the blood running into the cells under the skin. 
In elderly persons, the effects of sprains are very tedious, disabling 
them for many weeks, or even months. 

Treatment. — Elevate the limb, keep the joint perfectly quiet, and 
apply cold lotions, or fomentations. When the inflammation is all 



SURGICAL DISEASES. 463 



past, apply stimulating liniments, and bandages, or shower the part 
with cold water. 

Ruptures of Tendons. 

These accidents are known by a sudden snap, followed by pain, 
loss of motion in the part, and swelling and discoloration. 

Treatment — Place the part in such a position as to relax the broken 
tendon, the ends of which must be brought together, and retained in 
contact till they grow together. 

Diseases of the Bones. 

The bones are supplied with blood-vessels and nerves ; and as they 
live and grow like other parts of the body, so they beconie diseased 
and die in like manner. 

Ulceration of Bones. — Caries, 

Bones, like the soft parts, when attacked by violent inflammation, 
may ulcerate, discharge matter, and heal by granulation ; or, having 
lost a portion of their substance, may sink under entire disorganiza- 
tion and death. This disease passes in some parts of the country, 
under the name of " fever sore." 

Treatment. — Apply splints, and keep the part in a state of abso- 
lute rest. Subdue the local inflammation by the usual means. If 
the disease arise from scrofula or syphilis, use the remedies for those 
diseases. 

Death of the Bones. — Necrosis, 

This is like mortification of the soft parts. It occurs from injuries 
and inflammation of the periosteum. 

It is known by dull, deep-seated — sometimes acute — pain ; and is 
followed by increase of size, from the formation of new bone around 
the old, — the old being gradually broken into pieces, and discharged 
through external openings. 

Treatment. — Poultices and quieting fomentations. 

Unnatural Growth of Bones. — Exostosis. 

This disease consists either of a tumor of a bony nature, growing 
upon and arising from a bone, or an enlargement of a bone. It 
springs from the periosteum, or from the surface of a bone, or from 
its spongy texture. The enlargement or the tumor may be white 
and hard, like ivory, or dark-colored and spongy, or a mixture of the 
tw^o. 



464 SURGICAL DISEASES. 



At first, a tumor of this kind is not attended with pain or incon- 
venience. It comes on slowly, and sometimes remains nearly sta- 
tionary for several years. 

Treatment. — If the tumor be large and inconvenient, remove it 
with the knife. If not, use local pressure with pads and bandages ; 
also leech, blister, and restrict the patient to a spare diet 

Diseases of the Joints. 

Some of these diseases begin in the cartilages, some in the synovial 
membrane, and others in the heads of the bones. 

Disease of the Hip-Joint. — Coxalgia, 

This generally consists in inflammation of the synovial membrane 
and capsular ligament of the hip-joint, ending frequently in ulceration 
and destruction of the head and neck of the thigh bone. 

The symptoms are fulness in the groin ; pain, which is increased 
by motion ; aggravated when the limb hangs without touching the 
ground; is more felt in the knee than in the hip itself; and shoots 
down along the inside of the leg, as far as the instep. The thigh 
inclines forward, and the limb has the appearance of being longer 
than the other, — though in the latter stages, it is really shorter. 

Treatment. — Before suppuration takes place, apply leeches and 
blisters, and enjoin perfect rest. After suppuration, keep the patient 
upon his back, on a mattress, and mould to the parts thick paste- 
board splints, with pads, and give tonics. Keep the bowels open with 
senna and bicarbonate of potash, and rub the parts with iodide of 
potassium ointment, or with preparations (282) (283) (195). The 
disease being scrofulous, the iodide of potassium (140) may be taken 
with advantage internally. 

White Swelling.— Synovial Degenerations. 

There are several diseases of the knee-joint, characterized by swell- 
ing and white color from tension of the skin, which have passed 
under the common name of ivhite- swelling. The diseases are not 
strictly the same, but as they all affect the knee, and have symptoms 
to some extent in common, it is well enough to group them under 
the same title, — especially as one treatment is adapted to all. 

One is a pulpy disease of the synovial membrane. It begins with 
a trifling stiffness, and a slight swelling. The swelling increases by 
degrees, and on touching the part, there is a sensation as if it con- 
tained fluid. By and by the cartilages ulcerate. The disease is in- 
curable, as the synovial membrane is finally converted into a pulpy 
substance, and the limb has to be amputated. 

Another of these is inflammation of the synovial membrane, be- 
ginning with ulceration of the cartilages. It begins with pain in the 



SURGICAL DISEASES. 465 



joint, which is severe at one point, and attains its height in a week. 
In a day or two, the joint is swollen from a collection of water. 

Treatment. — Splints and entire rest, as in all chronic diseases of 
the joints. Also a generous diet, and whatever is calculated to build 
up the health. 

Bunions. 

This is an inflammation, enlargement, and hardening on the inside 
of the ball of the great toe. It is frequently connected with a distor- 
tion of the toe, which seems partially out of joint. The projection 
of the joint exposes it to great irritatic^n from the shoe, and to re- 
peated attacks of inflammation. It occasions great sufiering. 

Treatment. — Remove the pressure from the part, and '^en there 
is inflammation, keep the foot quiet and elevated upon a chair, apply- 
ing leeches, poultices, etc. Another method is to cover the bunion 
with soap plaster, spread on thick, soft leather, or, put the toe in a 
separate apartment of the stocking, like the finger of a glove. Then 
enclose it in a separate part of the shoe, which is contrived by fixing 
j,j^ jgg a piece of firm sole-leather in 

the bottom of the shoe, so as 
to make a separate compart- 
ment for the toe. 'By this 
means the pressure against 
the side is removed. Stick- 
ing plaster may be spread on 
wash-leather, and a piece cut out the size of the bunion. This will 
take off* a portion of the pressure of the shoe, and will hasten the 
cure. 

Fig. 166 represents a ganglion or tumor formed upon the synovial 
sheath of the tendon which bends the finger. 

Whitlow.— Felon. — Paronychia, 

This is an abscess of the fingers, of which there are tl?ree kinds, — 
the first situated upon the surface of the skin, the second under the 
skin, the third within the sheath which contains the tendons of the 
fingers, and sometimes involving the covering of the bone. 

The latter form of the disease is the most terrible, and begins with 
redness, swelling, and a deep-seated and throbbing pain, which grad- 
ually becomes so excruciating as to banish all sleep, and nearly drive 
the patient to distraction. Finally, matter forms and burrows in the 
deeper parts of the finger, and at length finds an opening, which 
brings relief. 

Treatment, — Carry the hand in a sling ; apply a leech or two, and 
use poultices. A poultice made of equal parts of powdered slippery- 
elm bark, poke root, blue flag-root, and lobelia seeds, mixed with 
hot ley, and changed twice a day, is an admirable application. 

59 




466 SURGICAL DISEASES. 



When these methods fail to stop the progress of the abscess, the 
finger should be laid open with the scalpel, cutting down to the bone. 
This will give vent to the matter, and the wound may be dressed 
with poultices, until the inflammation is subdued, and the healing 
process is well established, when some simple salve may be applied. 

Chilblains. 

This complaint should have been spoken of immediately after 
" frost-bite," but it was forgotten. It is caused by exposure to cold, 
and affects the fingers, toes, and particularly the heels, with a painful 
inflammatory swelling, of a red, purple, or bluish color. The skin 
may be red in patches, and slightly swelled, with itching, tingling, 
pain, and lameness ; or there may be blisters, around which the skin 
is blue or purple ; or, worse yet, there may be ulceration and slough- 
ing. 

Treatiueut. — Stimulating liniments are the remedies usually em- 
ployed for this complaint. One of the best consists of six parts of 
soap liniment, and one part of tincture of Spanish flies ; and another 
excellent one is prescription (307). K there is ulceration, use Turner's 
cerate, or the resin ointment. 

Stiff Joint. — Anchylosis, 

This is of two kinds, complete and incomplete^ — complete when the 
bones of the joint have become firmly united by bony matter, and 
incomplete when the motions of the joint are very much interrupted, 
but not entirely destroyed. The first is the result of ulcerations of 
the cartilages of the joints, and of the heads of the bones ; the latter, 
of fractures, sprains, bruises, thickening of the synovial membrane, 
and weakening of the muscles. 

Treatiuent, — No treatment is of much use in the first-named form of 
the disease. By sawing through the bone, and then daily moving the 
limb back and forth, a false joint may be made, but it is apt to grow 
together again, and finally defeat the purpose of the surgeon. When, 
however, stiffness arises from the weakening of the muscles, and some 
other causes involving the ligaments and tendons, something may 
be done by daily frictions with stimulating liniments, champooing, 
and warm fomentations ; and by gently bending the joint back and 
forth, several times every day, as much as can be done without pain. 

Tumors. 

A TUMOR is a swelling which consists of a new production^ not 
constituting any portion of the original structure of the body. There 
are several kinds of tumors ; but it is sufficient for my purpose to 
follow Mr. Ferguson, and divide them into the malignant and tion- 
malignant. 



SURGICAL DISEASES. 



467 



Cancer. 



Fig. 167. 



This belongs to the class of malignant tumors. It has two stages. 
The first is that of induration or scirrhus^ — during which it has, 
under the finger, the feeling of stony hardness. The second stage is 
that of ulceration or opeyi cancer. 

Cancer most often attacks the female breast, the skin, the mucous 
membranes, the tongue, the stomach, the neck of the womb, the lips, 
etc. It rarely occurs in subjects under thirty years of age, and not 
often in persons under forty-five. 

The S^Tuptoiiis of Cniieer, when it appears in the breast, are, a 
puckered condition, and dull, leaden color of the skin ; a hard, knotty, 
and uneven feel ; and occasional sharp 
pains. When it attacks the skin and mu- 
cous membranes, there is a hard, warty 
lump, which ulcerates, after a time, pro- 
ducing an open sore, with a hard base. 
(Fig. 167.) 

The sore of a cancer discharsfes an 
irritating, excoriating matter, which has 
a peculiarly fetid odor, so offensive and 
so different from any other smell, that it 
is seldom forgotten. The bones of a 
cancerous person break with great ease. 
Unmarried females are much more liable to the disease than the mar- 
ried. The cancerous growth is composed, in part, of cells, rounded 
or caudate, containing, as seen under the microscope, nuclei, younger 
cells, and granules. (Fig. 168.) 




Fig. 168. 



Fig. 169. 



Fig. 170. 






The difference between these cells and those of common pus glob- 
ules may be seen by comparing Fig. 168 with 169, — the latter being 
pus corpuscles highly magnified by a powerful microscope. Fig. 170 
represents pus globules not so much magnified. 

Treatment, — There are but two methods of treatment which prom- 
ise any success. The first is to extirpate the tumor by a surgical 
operation before the disease has so far invaded the constitution as to 
be sure of returning. The other is that adopted by Dr. J. W. Fell, 



468 SURGICAL DISEASES. 



an American physician, who was permitted to try his remedies in 
one of the English hospitals, and who drew from the surgeons in 
charge of it a favorable report of the results. 

Dr. Fell's remedies are mainly blood-root and chloride of zinc (336) 
made into a paste. The skin over the tumor is first destroyed, and 
this paste, spread upon strips of linen, is applied. This causes an 
eschar, into which incisions are made, half an inch apart, taking care 
to avoid the living tissue: The same paste spread in a like manner 
is then daily inserted into the furrows. By this means, which is orig- 
inal with Dr. Fell, the effect of the caustic penetrates through all 
parts of the tumor, causing the whole diseased mass to fall off, and 
leave a healthy, granulating surface. 

In incipient cancer, where the disease has not made much progress, 
Dr. Fell uses the above, which he calls a brown ointment (336), and 
in donnection with it an ointment of the iodide of lead (337), using 
each twelve hours. With these, he claims that he cures incipient 
cancers, with great readiness. He also employs, internally, half-grain 
doses of pulverized blood-root (143), with arsenic and cicuta. 

Dr. Fell claims that with these preparations, he has often cured 
hpus^ and has been very successful with them in treating indolent 
ulcers. 

Soft Cancer.— Bleeding Cancer. 

Medullary Cancer. — Encephaloid Tumor. — Fungus Hematodes, 

This varies in size from a nutmeg to a child's head. Its color 
varies from white to deep red. At times, it is soft and elastic at 
first ; at other times, it is firm and tense. The patient is wan and 
pale from the beginning. The parts do not ulcerate, as in scirrhus ; 
but after the skin is broken, a spongy bleeding tumor protrudes. 

Treatment — Dr. Fell's method. 



Black Csincei,— Melanosis. 

This is an organic disease, in which the tissue of the disordered 
part is converted into a black, hard substance, which is converted 
into ulcerous cavities. This often appears in the lungs, and is met 
with in the liver and other parts. 

Its symptoms are, a sallow complexion, great debility, and dropsi- 
cal swelling of the limbs before the termination. 

Treatment. — When it appears externally. Dr. Fell's treatment is 
worth a trial. When in the lungs, the inhalation of tincture of blood- 
root and solution of chloride of soda (241) should be used. Two 
teaspoonfuls may be put in Warren's Vapor Inhaler, — the instru- 
ment being filled half full of hot water, — and inhaled ten minutes, 
three times a day ; the blood-root pills (143) being taken at the same 
time. 



SURGICAL DISEASES. 469 



Fatty Tumor. — Adipous Sarcoma. 

This is the most common of all the forms of tumor. These bodies 
generally have a soft and doughy feel, or as if filled with wool. They 
are the least inclined to become malignant, and consequently the least 
dangerous, of all the tumors. Whatever pain there is, is caused by 
their size, weight, and pressure. They are occasionally found a little 
below the point of the shoulder, in the deltoid muscle of females, and 
are caused by the unreasonable pressure of the dress at that point. 

Treatineut, — They should be removed by an operation, which is 
easily performed, as they separate very readily from surrounding 
parts. 

Polypus. 

The polypi constitute a class of tumors growing from mucous 
membranes. They are of two kinds, — the soft^ jelly-like polypus, 
and the Jieshy ox fibrous polypus. 

The Soft Polj'pus, which grows from the nose, has not much feel- 
ing, and is not particularly disposed to bleed. 

The Fleshy PoljlJUS is firmer and harder than the preceding, and 
most generally connects itself with the womb. 

Treatment. — Both kinds of polypi are either twisted off with a 
pair of forceps, or strangled by putting a string, called a ligature, 
around their neck, which will cause them to fall off in a short time. 

Wens. — Encysted Tumors. 

The most common situation of these is under the skin of the head. 
A wen is simply a sac full of various matters, which, when examined 
with a microscope, are found to be oil globules, epithelial cells, and 
crystals of stearine. These contents are secreted by the internal 
surface of the sac. They sometimes look like curd or rice, sometimes 
like suet, and sometimes like honey. In other instances, they are 
mere water, and they have been known to consist of hair or horn. 
These tumors are round, elastic, and movable, and are without pain. 
They grow slowly, but steadily. 

Treatment. — The attempt to excite inflammation and consequently 
absorption, by punctures, seatons, or injections, are dangerous, and 
ought not to be resorted to. If the tumor is small, its opening, indi- 
cated by a small black spot, may be found, a probe be introduced 
into it, and the contents of the sac be squeezed out ; and this may be 
repeated as often as necessary. But the proper and only real remedy 
for these tumors is their removal by a surgical operation. 



470 SURGICAL DISEASES 



Aneurisms. 

An aneurism is a tumor formed by arterial blood, and communi- 
cating with an artery. A true aneurism is formed by the coats of an 
artery getting weakened by some cause, and swelling out so as to 
form a pouch or sac. (Fig. 171.) There are other kinds of aneu- 
risms^ which need not be described. 

Fig. in. 




Symptoms. — An aneurism may be felt as a tumor somewhere 
along the course of an artery, and it beats under the finger like the 
pulse. The beating is caused by a fresh quantity of blood being 
pushed into this sac with every stroke of the heart. If it be small, 
pressure on the artery above it will so far shut off the blood from it, 
that it will feel flaccid or soft. The patient will often say that the 
tumor began to appear after some violent strain, when something 
appeared to give way. In the chest, aneurism will produce an un- 
natural pulsation felt by the patient. In the belly, it may generally 
be felt as a tumor through the abdominal walls. 

Distinction. — Tumors which lie directly over arteries are lifted up 
every time the blood is driven along under them, and hence they 
pulsate like aneurisms ; but they do not pulsate when small, whereas 
aneurisms do from the beginning of their growth. Aneurisms are 
soft at first, and hard afterwards ; whereas tumors are generally hard 
at first, and finally soft. 

Treatment. — In some few fortunate cases, aneurisms get well spon- 
taneously. If the flow of blood through them can be stopped, that 
which is within them will coagulate, forming a hard tumor, which 
will gradually waste away. To cure them, therefore, we must stop 
the circulation through them ; and this may be done, in some cases, 
by compression. The pressure upon the artery must of course be 
above the tumor, and should not be so great as to stop the blood 
altogether, but only very materially to diminish its flow. The pres- 
sure is applied by an instrument having two pads, an arc of steel, a 
joint in the middle, and a screw by which the padded extremities are 
pressed together. (Fig. 172.) 

When this mode of treatment is not practicable, the artery must 
be tied between the aneurism and the heart. The patient should be 
placed in bed, with the limb wrapped up to preserve its temperature, 



SURGICAL DISEASES. 



471 



and placed in an easy position. Nothing cold should be applied 
to it. 

The force of the circulation should be reduced by the tincture of 
veratrum. 



Fig. 172. 



Fig. 173. 





Br onchocele.— Derbyshire Neck. — Goitre. 

Bronchocele is what is called an endemic disease ; which means, 
a disease ichich prevails in certain localities. This complaint is prev- 
alent in Nottingham and Derbyshire, England, among the Alps, and 
especially in the Tyrol and valley of the Rhone. It is thought to be 
produced by the use of melted snow, and water impregnated with 
lime and earthy matter. 

Sjinptoms. — A prominent, soft, elastic tumor, occupying the front 
of the throat, in the situation of the thyroid gland, and like it in shape. 
It is not tender, and the skin is not discolored. In old cases, the 
tumor becomes hard. In Fig. 173, the tumor is so large as to have 
pushed the gullet to one side. 

Treatment. — The usual and perhaps the best remedy for this dis- 
ease is iodine. It may be given as iodide of potassium, with a bitter 
or some other article (138) (145) (101). An iodine ointment may be 
applied to the tumor (185). 

The patient should move away from the infected district, and re- 
side, if possible, upon the sea coast. 



Water in the Scrotum. — Hydrocele, 

As the name shows, this is a collection of water in the scrotum or 
bag which holds the testicles. 

Symptoms. — It presents a swelling, shaped like a pear, smooth on 



472 SURGICAL DISEASES. 



its surface, fluctuating if pressed, without pain, but causing a little 
uneasiness by its weight. On placing a lighted candle on one side 
of the scrotum, the light may be seen through it. * 

Distiuctioil. — This complaint may^be distinguished from a solid 
enlargement of the testicle by its not being so heavy, solid, or painful, 
and by its fluctuating and being transparent ; from rupture, by its 
forming slowly instead of suddenly, by the swelling beginning at the 
lower part of the scrotum instead of the upper, and by the enlarge- 
nient not being increased by coughing as it is in rupture. 

Treatment. — In children, strong scattering washes (353) are some- 
times successful. But most commonly, a number of punctures are 
made with a large needle, to cause the fluid to escape into the cell 
tissue of the scrotum, whence it is removed by absorption. 

To effect a radical cure in grown persons, the surgeon is to grasp 
the tumor behind, and introduce a trocar and canula into the sac, — 
being careful to point the instrument upwards, so as not to wound 
the testicle. The trocar is then withdrawn, — the canula being at 
the same time pushed well into the sac, so that none of the fluid may 
get into the cell tissue outside the sac. The fluid runs ofl* through 
the canula. When this has all escaped, some stimulating fluid, as 
common lime-water, or, still better, tincture of iodine, is to be injected 
through the canula into the emptied sac. After retaining this from 
two to five minutes, it is permitted to flow out. Inflammation fol- 
lows, which breaks up the secretion of water, and effects a cure in 
two or three weeks. The amount of fluid thrown in, should be about 
one or two teaspoonfuls of a mixture of one part of tincture of iodine 
and two parts of water. If the first operation does not effect a com- 
plete cure, it may be repeated. 

Blood in the Scrotum. — Hcematocele, 

This is a collection of blood in the scrotum from some injury. 

Treatment, — If the quantity of blood effused be smaU, cold appli- 
cations may cause it*to be absorbed. If it be large, make a puncture, 
and apply a poultice for the blood to ooze into. 

Acute Inflammation of Veins. — Phlebitis, 

The veins are subject to attacks of acute inflammation, which 
constitutes a very dangerous, and often fatal, disease. 

SjTiiptoms. — Fits of shivering, or perhaps fainting, a rapid pulse, 
anxiety of countenance, lowness of spirits, catching pains about the 
heart, and swelling", redness, tenderness, and hardness along the course 
of the affected veins. Sometimes the tongue is furred brown or black, 
the skin is sallow, there is bilious vomiting, low delirium, and death. 
In cases less rapid, there are great swelling and redness over the dis- 



SURGICAL DISEASES. 473 



eased veins, and abscesses form, which, when opened, reveal clots of 
blood, mixed with pus. Or, the patient, while remaining low, with a 
sallow countenance, and a yellow tongue, will complain suddenly of 
intense pain in some joint, as the knee or shoulder, — - in which there 
will be a rapid formation of pus ; a similar suppuration will follow 
in other joints as well as in the lungs, etc., until the patient sinks, and 
dies of exhaustion. 

Treatment. — Apply leeches freely over the inflamed veins, — also 
fomentations. Every abscess should be opened early. Keep the 
bowels moderately open with some preparation of salts, and allay 
pain and restlessness by morphia. Support the strength by beef tea, 
etc. ; and, if the pulse be feeble, give wine or quinine. 

The suppuration may be checked, in this as in other complaints, 
by drinking freely of chamomile tea. The power to control sup- 
puraton has recently been discovered as belonging to chamomile 
flowers. 

Chronic Phlebitis. 

This is a far less serious disease than the preceding. It generally 
affects the veins of the legs. 

Sjiiiptoms. — Tenderness and hardness of the affected vein, with 
swelling around it, and of the parts below; a general painfulness of 
the limb. After the inflammation has subsided, the vein feels hard, 
like a cord, because the inflammation causes the blood within to co- 
agulate, and harden, so that nothing can pass through the vessel. 

Treatment. — Leeches, fomentations, or cold lotions, as the patient 
may choose, purgatives, and rest, with the limb elevated. Subse- 
quently, when the inflammation seems completely subdued, friction 
with camphorated oil, and bandages. 

Enlarged or Varicose Veins. — Varia^, 

The veins which lie near the surface, especially those of the legs, 
are apt, by exhausting labor upon the feet, and by strains, to get 
weakened, so that their valves lose their tone, and their sides stretch 
and give way in certain places, letting the blood bulge out, and form 
purple bunches. These bags of blood, lying along upon the surface 
of the limb, form knotty tumors, looking like blood-boils. They oc- 
casion a kind of distress, but no sharp pain. 

Persons of weak, soft, and relaxed muscles and blood vessels are 
particularly liable to this complaint. It often attacks women in the 
family way. 

Treatment. — Where only a few veins are affected, it may be 
sufficient, in some eases, to apply firmly over them a few strips of 
leather, spread with soap plaster. But generally it is better to sup- 
port the whole limb with a good calico bandage, or with a laced stock- 

60 



474 SURGICAL DISEASES. 



ing, which should be applied in the morning before the patient is up. 
It is generally well, also, to use friction, with some liniment, or iodine 
ointment. Lead water, or alum water, or an infusion of white oak 
bark, may be used with advantage. Burdock and plantain leaves, 
bound upon the skin, and removed before they are dry, are useful. 
Showering with cold water strengthens the veins. 

Rupture. — Hernia, 

Hernia signifies a protrusion of any internal organ from the cavity 
where it belongs ; but the term is generally restricted so as to mean 
no more than a protrusion of the boivel through the walls of the belly. 

When the abdominal walls are weak, from any cause, no matter 
what, — lifting, straining, or making violent muscular exertion of any 
kind, will then often cause the bowel to force itself through at the 
most, debilitated spot ; and pushing the lining of the belly, the peri- 
toneum, along before it, a bag or sac is formed, in which the project- 
ing bowel is enclosed, forming an external tumor. 

Divisions of Hernia. — Rupture may occur in several different 
places, and has accordingly received different names. 

Umbilical Hemia is a protrusion of the bowel at the umbilicus 
or navel. This is most common in children soon after birth ; and 
women who are often pregnant are liable to it. 

Ventral Hernia is that which occurs at any part of the belly where 
other forms of rupture do not appear. 

Inguinal Hemia is that in which the bowel protrudes at the groins, 
or through the abdominal rings. 

Scrotal Hemia is that in which the bowel descends into the bag or 
scrotum. 

Femoral Hemia is the dropping down of the bowel behind what 
is called Poupart's ligament, and appearing as a tumor at the upper 
part of the thigh. 

Reducible Hemia. — Rupture is said to be reducible, when the 
bowel may be put back into the cavity from which it came. 

Irreducible Hemia. — Hernia is called irreducible when the pro- 
truding bowel cannot be returned into the belly. 

Strangulated Hemia is that form of the complaint in which the 
bowel is so pressed upon at the point where it passes through the 
walls of the belly that it is strangled or constricted so that its contents 
cannot pass through. 

Symptoms of Hemia. — A soft tumor, which may be compressed, 
appears somewhere about the belly; and is increased in size when 
the patient stands up. It also swells when he coughs, or makes any 
exertion ; and grows smaller, or entirely disappears, when he lies 
down. 



SUKGICAL DISEASES. 47e5 



Treatiiieiit. — In a case of reducible hernia, the first thing to be 
done is to put the bowel back in its place, which is accomplished by 
gently pressing and kneading the tumor, and swaying it back and 
forth, — being careful to use no violence, — until it can be pushed 
within the abdominal walls. It is then to be kept in its place by the 
use of a truss, made expressly to fit the case. This instrument should 
be constantly worn by day, and by night, too, if not too irksome ; but 
if worn by day only, it should always be applied before rising in the 
morning. 

Irreducible Hepiiia may be palliated by wearing a truss with a hol- 
low pad, which will so evenly and firmly embrace the tumor as neither 
to irritate it, nor permit any further protrusion or enlargement. 

Strangulated Hernia. — If a person have worn a truss for some 
time, and, suddenly leaving it off, makes some violent exertion, either 
the bowel or omentum is liable to be suddenly forced through a nar- 
row aperture, and to become strangled. In such case, the patient has 
flatulence, colicky pains, a sense of tightness across the belly, and a 
desire to go to stool, but no ability to pass anything. Then follows 
vomiting, first the contents of the stomach, then mucous and bile, 
and, lastly, the fecal matters from the bowels, w^hich are not permitted 
to pass on to their natural outlet. The neck of the hernial sac now 
becomes swelled, tender, and painful, the countenance is anxious, and 
the pulse small, hard, and wiry ; and, after a time, the tumor begins 
to mortify, the patient expresses himself free from all pain, and soon 
after dies. 

In the treatment, the bowel is to be returned if possible. To do 
this, the bladder should first be emptied with a catheter, and the 
patient should lie down with his shoulders raised, and both his thighs 
bent towards the belly, and placed close to each other, so as to relax 
all the ligaments and muscles of the belly. The surgeon may now 
work gently for half an hour, if necessary, trying to put the bowel 
back, but must be very careful not to excite inflammation by any 
violence. 

If he does not succeed, efforts are next to be made still further to 
relax the muscles, as well as to reduce the force of the heart's action, 
and to diminish the size of the tumor. With the tin-cture or fluid 
extract of veratrum viride, the heart's action and force of the circula- 
tion may be reduced to any desirable extent. The muscles may be 
relaxed by injections of tobacco, made by steeping one dram of to- 
bacco in one pint of water for ten minutes. This, however, is a 
somewhat dangerous remedy, and should give place to the compound 
lobelia injection. Two grains of tartrate of antimony in one pint of 
tepid water, make a suitable injection. 

To reduce the tumor, apply pounded ice in a bag, or a freezing 
mixture (354). If the pain be acute, give large doses of opium or 
morphia. 

If all these remedies fail, there is then no hope but in relieving the 
stricture by a surgical operation. 

General Directions. — Rupture is an exceedingly common affection. 



476 SURGICAL DISEASES. 



Perhaps every third or fourth person suffers from it more or less. 
Females, from motives of delicacy, are apt to conceal the misfortune, 
and not seek advice. This exposes them to danger. Queen Caro- 
line, wife of George IL, lost her life by such concealment. 

A swelling coming on suddenly in the groin or at the navel, after 
considerable exertion, may be taken to be a rupture without much 
fear of mistake. 

The complahit being discovered, the bowel should be put but back 
in its place, and a truss be put on at once. In the case of young 
persons, a truss may frequently effect a cure, but, tl^at it may do this, 
it should not be taken off, night or day, except to cleanse it, and then 
only when the wearer is in bed. 

Those who can afford it, should have two trusses of the same size 
and strength, so that if one get out of order, the other may take its 
place while it is being repaired ; for, an hour's absence of the truss 
might occasion a mischief which it would require months to repair. 

Persons having a rupture must be very careful to keep costiveness 
at a distance ; for straining at stool is highly injurious. 

Varicocele.— Cirsocele. 

This is an enlargement or varicose state of the spermatic veins, 
and may be mistaken for hernia, inasmuch as standing and coughing 
increase it. But it feels like a bag of worms ; and by this peculiarity, 
may be distinguished from rupture.. 

Treatment. — Wear a suspensary bandage. 

Deformities and Irritations of the Spine. 

Lateral Curvature. — There are several varieties of curvature of the 
spine. Some of them are caused by the destruction of some portion 
of the spinal column by disease. It will not be necessary for me to 
treat of these forms of curvature, as they can only be investigated and 
treated by the most skilful surgeons. Those who will use this book 
chiefly, would hardly think of meddling with them. 

The curvature which arises from debility of the bones, ligaments, 
and muscles, and which is very common among females, has the 
following 

Symptoms, — At first there is a projection of one collar-bone, or one 
side of the chest, or one shoulder is considerably elevated, and is 
popularly thought to be '^groiving ouV^ On examination, the right 
shoulder and the right side of the chest will be found, generally, to 
be rounded and lifted up, while the other is sunk down and concave. 
At the same time, the left hip sticks out, and the loins on the right 
side have an inward curve. The spinal column will have a curve, as 
in Fig. 174. 

Causes. — This affection is caused by occupations which keep the 
body in a laterally distorted position, and tax one side of the body 



SURGICAL DISEASES. 



477 




more than the other. It is produced in children who study their 
les^sons at school with one elbow resting on a high desk. The 
muscles, too, get so weakened in many ^la, lu. 

females of luxurious, sedentary, and indo- 
lent habits, that they cannot hold the bony 
frame of the body in an upright position, 
and the jointed column of bones, called 
the spine, sags down to one side, and 
draws the whole skeleton of the trunk out 
of shape. 

Trentnient. — The first thing to be done 
is to learn what particular attitude of the 
body has occasioned the distortion. This 
discovered, every possible effort is to be 
made to break up the habit, whatever it 
may be. If it be standing on one foot, or 
sleeping on one side, or reading or writ- 
ing with the elbow high, keep a constant 
watch and strict rule over the patient. 

Exercise in the open air should be free, 
and taken daily. The use of the dumb 
bells is excellent for both sexes ; but girls 
should, in addition, have all the variety of elegant exercise furnished 
by calisthenics. Wealthy parents, whose daughters are tenderly bred, 
should never let them grow up without the invigoration which these 
exercises impart. 

When the curvature is marked, and the debility considerable, these 
vigorous exercises should be taken for a time with moderation, and 
the patient should lie down and rest immediately after taking them. 

In many cases considerable benefit is derived from the mechanical 
support afibrded by supporters of various kinds. These are now con- 
structed and adapted to the body, with considerable skill, by those 
who make their construction a study and a business. 

Spinal Irritation. — The spinal column is liable at certain points, 
to become congested, and consequently sore and irritable. 

Symptoms. — The symptoms of this state of things are very varia- 
ble and numerous, as all sorts of sensation of the skin, from utter 
numbness and insensibility up to the most acute sensitiveness, des- 
cribed as creeping, shooting, coldness, tingling, and the crawling of 
ants. There may be neuralgic pains, spasm, cramp, trembling, or 
palsy of the voluntary muscles ; or a fixed pain and tenderness in 
some joint or other part ; or palpitation of the heart, dizziness, and 
wind and pain in the stomach. 

When any of these symptoms appear, and cannot be traced to any 
other cause, we are to suspect some irritability of the spinal column, 
and to search, accordingly, in that direction. The proper method of 
search is, to make firm pressure on each of the projections of the 
spine, and to pass over the projections a sponge wrung out of hot 



478 SURGICAL DISEASES. 



water. If there be trouble here, the patient will now be likely to 
complain of severe pain at some one point. Or, the tender place 
will generally be found sooner, by tapping with the ends of the fin- 
gers, with quick and sharp strokes along upon the projecting bones 
of the spine. The patient will be pretty sure to wince when the 
tender point is reached. 

Treatment, — Apply leeches, and follow them with a blister, or 
stimulating liniment, or some strong, slightly irritating plaster, and 
the tenderness will be very likely to disappear, as if by magic. 

Wry Neck. — Caput Ohstipiim, 

In this complaint, the head is drawn over towards one of the shoul- 
ders, with the face generally turned towards the opposite side. This 
is caused by the rigid contraction of a particular muscle. In some 
instances, however, other muscles are affected, and the head may be 
drawn in other directions, or be twitched about in various ways. 

I had a singular case from New Hampshire, which, though not 
exactly wry neck, was a kindred disease, and is worthy of being men- 
tioned. The subject of it was a young lady of good physical develop- 
ment, but inclined to nervous complaints. Her head was chiefly drawn 
over backwards, sometimes so as to lie for a short time flat upon the 
back, with no power to raise it. She was obliged, ordinarily, to let 
her head lean a little to one side, and rest upon the hand, in order to 
keep it steady. When walking, with the head erect, without this 
support, it was every few moments jerked over backward and a little 
to one side, the chin being thrown up in a most unseemly way. The 
case partook of the nature of chorea. 

Treatment, — For the genuine wry neck, where the muscle which 
draws the head to one side is rigid and inflamed, the treatment 
should consist of leeches, poultices, purgatives, blisters, and alteratives. 
When the muscles causing the distortion are not rigid, electro-mag- 
netism, or the shower bath may have a good effect. In some cases, 
strychnine will do well. 

The peculiar case mentioned above, completely recovered, under the 
uses of the extract of St. Ignatius's bean (95), one pill three times a 
day, and gradually increased to nine pills a day. She also took iron, 
and was put upon a most energetic system of out-door exercise. 
Considering the stubborn and severe nature of the complaint, her 
complete recovery was as unexpected to her friends as it was grati- 
fying- 

Toreign Bodies in the Eye. 

When a person complains of some substance in the eye, the inside 
of the lower eyelid, and lower portion of the ball, should first be ex- 
amined, the person being directed at the same time to look up. If 
nothing be discovered there, the patient is then to be directed to look. 



SURGICAL DISEASES. 479 



downward. This will expose to view the upper part of the globe. 
At the same time, the eyelashes should be taken between the thumb 
and finger, and the l^d turned upward over some round smooth thing, 
as a bodkin, which will turn the lid wrong side out, and bring to view 
whatever is on the inner surface. Any foreign body discovered may 
be removed by wiping it off with the head of a pin, having a silk 
handkerchief turned over it. If this fails to detach it, it may be care- 
fully picked up by running under it the point of a lancet, tooth-pick, 
or pen-knife. 

Stye. — Hordeolum, 

A STYE is nothing more nor less than a small painful boil at the 
edge of the eyelid. 

Treatment. — In severe cases, apply a poultice ; and open it as soon 
as it begins- to point. After it has discharged all it is likely to, apply, 
on going to bed, for two or three nights, a little diluted nitrate of 
mercury ointment. Tonics and alteratives are frequently required to 
break up the formation of styes. 

Inflammation of the Edge of the Eyelids. 

Ophthalmia Tarsi. 

This inflammation often involves the Meibomian glands, which 
then secrete a sticky mucus, which, not being wiped away during 
sleep, glues the lids together, so that, on waking in the morning, the 
patient cannot get his eyes open. The complaint is generally chronic 
and obstinate, lasting a long time. Weakly persons, with disordered 
digestion, are most subject to it. In some cases the lids ulcerate, and 
the lashes fall out. Generally the lids are considerably inflamed for 
a few days, and then, the inflammation subsiding, branny scales, 
which may be brushed off', form along the borders of the lids, at the 
roots of the lashes. 

Treatment. — The health being generally disordered, needs first to 
be improved by all possible means, as by alteratives, tonics, bathing, 
exercise in the open air, travelling if practicable, and a generous diet. 

While the lids are inflamed, they should be bathed by a wash com- 
posed of sulphate of zinc, twelve grains ; laudanum, two drams ; and 
soft water, twelve ounces. The redness and heat having subsided, 
and the bowels being opened by a gentle dose of physic, an astrin- 
gent wash should be applied once or twice during the day (208) 
(209), and a small piece of the diluted nitrate of mercury ointment 
be rubbed along the borders of the lid, with a pencil-brush at night. 
This will generally effect an immediate improvement, and in time 
will bring about a cure. 



480 SURGICAL DISEASES. 



Disorder of the Lashes. 
Trichiasis, — This signifies a growing inward of the eyelashes. 

Dystrichiasis, — This is a double row of eyelashes, one of which 
grows inward. 

Treatment. — Pull out the misplaced hairs, and continue to do so 
as fast as they appear. 

a 

Ptosis. 

This is a falling down of the upper eyelid, from palsy of the third 
nerve. It is sometimes attended with headache, and dizziness, and 
may be the forerunner of apoplexy. 

Treatment. — Begin the treatment with purgatives, and then use 
every means to improve the health, especially exercise out of doors. 

Chronic Inflammation of the Lachrymal Sac. 

When the mucous lining of the nasal duct gets thickened and 
obstructed, the patient complains of great weakness of the eye, which 
is constantly weepings — the nostril on the same side having a corres- 
ponding dryness. The tears not passing down through the obstructed 
duct, collect in the lachrymal sac, and form a small tumor by the side 
of the nose. By pressing the finger upon this, the tears may be 
squeezed out through the upward passage, and glairy mucus along 
with them. There is generally tenderness of the sac, and sometimes 
redness of the skin. There is commonly inflammation of the mucous 
membrane lining the eyelids, etc. 

Treatment. — The acute inflammation of the sac must be treated 
by leeches, purgatives, and cold washes. 

Chronic inflammation of the sac requires a special attention to the 
general health. The diet should be carefully regulated, and the alka- 
line sponge bath used every day, with brisk rubbing after it. When 
the sac gets very full, the patient should try gently to force the con- 
tents down into the nose by pressing upon the upper side of the 
tumor ; and he may promote the same object by strongly drawing in 
his breath often with his mouth and nostrils both tightly shut. The 
diluted nitrate of mercury ointment may be applied to the eyelids at 
bed-time, and a little of prescription (211) may be dropped once dur- 
ing the day into the inner corner of the eye. 

Purulent Ophthalmia. — Egyptian Ophthalmia, 

Owing to the glaring sunshine, and the particles of sand with 
which the air is loaded, this disease is endemic in Egypt. Hence its 
name Egyptian opthalmia. 



SURGIC.VL DISEASES. 481 



Symptoms. — It begins with stiffness, itching, and watering of the 
eyes, and a feeling as if there were dust in them. The lids are a 
little swelled, and become glued together during sleep. The mucous 
membrane which lines the lids and covers the ball, is intensely red 
and swollen, and discharges a copious quantity of pus. There is a 
severe burning pain extending to the cheek and temple, with head- 
ache and fever. The eyes cannot be opened. It is both contagious 
and infectious. 

Treatment. — At the very beginning, apply a nitrate of silver wash 
(211), twice a day. With this application, a low diet, and five to 
ten-drop doses of fluid extract or tincture of veratrum viride, every 
hour, this terrible complaint may often be broken up. 

If the disease have reached its height, and there is great fever and 
headache, the patient may be freely purged (31), and the pain be 
allayed by full doses of Dover's powder. 

The patient must be kept in bed, in a dark room, with the head 
elevated. 

The eyes should be frequently washed out gently with warm water, 
or a decoction of poppies, containing one grain of alum to an ounce. 
This must be done with a piece of fine sponge, or with a small 
syringe. Once or twice a day, a few drops of solution of nitrate of 
silver, two grains to the ounce of soft water, may be dropped in 
the eyes from a camel's-hair pencil. As soon as the disease begins 
to give way, the alum in the poppy decoction may be increased a 
little. 

Purulent Ophthalmia of Children. 

This always begins within a short time after birth, — generally 
on the third day. 

Symptoms. — The edges of the lids at first become red, and glued 
together, and the membrane lining them is red and rough. The eye 
remains closed. The conjunctiva or membrane which covers the 
globe, next becomes intensely scarlet, and so much swelled, at times, 
that the lids turn out ; and it discharges a thick purulent matter. 
The child is feverish and restless. 

Causes. — Exposure to cold and damp, bad nursing, omitting to 
wash away from the eyes the cheesy secretions of the skin, and the 
contact of gonorrhceal and leucorrhoeal secretions of the vagina at 
birth. 

Treatment. — Wash out the eye frequently, and gently, with a 
weak astringent wash (207) (203), or put between the lids once a 
day, a large drop, with a camel's-hair pencil, of prescription (208). 
When the disease is declining, apply to the lids, with a camel's-hair 
pencil, diluted nitrate of mercury ointment. 

61 



482 SURGICAL DISEASES. 



Catarrhal Ophthalmia. 

Symptoms. — In this complaint, the white of the eye becomes in- 
flamed and very red, the redness being superficial, so that the vessel 
can be moved by pulling the eyelids ; generally there is a thin mucous 
discharge, which, in severe cases, becomes thick and purulent. It is 
caused by cold and damp. 

Treatment. — If there be considerable pain and headache, give pur- 
gatives (31) (19), and continue them, once a day, till the symptoms 
of active inflammation subside. Apply to the eyes a poultice of 
slippery elm, and bathe them frequently with a decoction of poppy 
leaves, lukewarm or cold, according to the choice of the patient. 
Smear the edges of the lids at night with fresh lard ; and when the 
inflammation begins to decline, use diluted nitrate of mercury oint- 
ment instead. Keep the eyes well protected from the light with a 
shade. A large drop of a solution of nitrate of silver, two to four 
grains to the ounce of water, may be put into the eye two or three 
times a day. Sometimes sulphate of zinc, four grains to the ounce 
of water, will do well. 

When the disease reaches the chronic stage, — the pain and head- 
ache having passed ofl*, — some astringent applications will be re- 
quired, as a very weak solution of nitrate of silver (208), or a dram 
each of powdered witch hazel leaves and golden seal, steeped for ten 
minutes in a gill of boiling water, and strained when cold. 

Scrofulous Ophthalmia. 

This disease is chiefly confined to children under eight years of 
age. 

Symptoms. — Entire inability to bear light ; the lids are spasmodi- 
cally closed, and the head constantly turned away from the light. The 
blood vessels of the conjunctiva are not particularly injected, with 
the exception of one or two large ones which run towards the cornea, 
and terminate in one or more small opaque pimples. The cornea 
frequently ulcerates, and the complaint is very obstinate, — being 
liable often to recur. 

Treatment, — As in all scrofulous complaints, it is important in 
this to look after the general health. No more physic is required 
than to keep the bowels open ; and even this, if costiveness exist, 
had better be done by bread m^We from unbolted wheat flour, by 
injections of cool or tepid water, and by exercise. The health must 
be supported by iron, sarsaparilla, stillingia, and quinine. 

The eye is to be strengthened by cold water applied to the lids, the 
forehead, and the temples. The eyes may be bathed likewise with a 
warm decoction of poppies, or of chamomile flowers. 

But one of the best applications is a solution of nitrate of silver, 
one or two grains to the ounce of water, a few drops being put into 



SURGICAL DISEASES. 483 



the eye once or twice a day. Occasionally a solution of sulphate of 
copper, of the same strength, may be used with decided advantage. 
Both eyes should be protected by a shade. 

Inflammation of the Cornea. — Comeitis, 

Symptoms. — The cornea is rough, red, opaque, and generally prom- 
inent There is some pain and inability to bear light, but not great. 
The pulse is frequent, and the skin dry. 

Treatment, — If the inflammation be acute, use leeches, emetics, 
purgatives, tincture of veratrum. Apply fomentations, and smear 
belladonna ointment on the eyebrows. 

For the chronic form, give quinine and other bitters, and put blis- 
ters upon the nape of the neck, and behind the ears. The wine of 
opium, and the diluted nitrate of mercury ointment, must be applied 
to the lids. 

Inflammation of the Iris. — Iritis. 

The iris is covered with a serous membrane, and is very liable to 
adhesive inflammation. 

Symptoms. — In the first stage, the iris changes its color, and the 
pupil is contracted. In the next stage, lymph is poured out upon the 
surface in a thin layer, sometimes, which looks rusty, and sometimes 
in larger quantities, filling the whole cavity of the aqueous humor. 

Causes. — Injuries, or overworking the eye, but more frequently a 
taint of the system from gout or syphilis. 

Treatment. — If there be considerable inflammation, apply leeches 
to the temples, and keep down the circulation by tincture of vera- 
trum. To relieve pain, if any, give Dover's powder, or morphia. 
The strength is generally to be supported by quinine ; and in many 
instances, iodide of potassium is to be given as an alterative. A little 
solution of atropia, one grain to the ounce of water, is to be dropped 
into the eye once or twice a day, and a warm infusion of slippery 
elm bark, or of marshmallow, to be used as a wash. The bowels to 
be kept open by gentle physic. 

Weakness of Sight. — Muscce Volitantes. 

This is an affection to which persons of weakly constitution are 
liable, and those who write much, or examine very small objects. 

Symptoms. — Dimness of sight; uneasiness on exposure to a strong 
light ; and specks floating before the eyes, — often looking like flies. 

Treatment. — The complaint depends on debility, natural or ac- 
quired ; and tonics, as quinine and iron, and the shower or sponge 
bath, and out-door exercise, are the proper remedies. 



484 SURGICAL DISEASES. 



Imperfect Vision. — Amaurosis, 

The complaint here referred to is dependent on some change in 
the optic nerve or the brain, — most commonly the former. 

Symptoms. — In some cases the sight becomes suddenly dim, and 
is perhaps soon lost altogether ; but more often it is impaired by slow 
degrees, — being only defective at intervals, as when the stomach is 
out of order, or the eyes have been fatigued. At one time, it will 
begin with objects appearing dim ; at another, with their being 
double ; at still another, with the ability to see only one half of 
objects. In some instances, the complaint begins with a crooked, 
or disfigured, or discolored appearance of things looked at. Again 
it will begin as near-sightedness, or far-sightedness ; or the patient 
cannot measure distances, and will miss his aim in pouring water 
into a glass, or in putting a match to the wick of a lamp. The flame 
of a lamp will appear split. At times the eye does not bear light ; 
at other times 'it longs for it, and objects do not appear illuminated 
enough. 

Distinction. — Amaurosis may be distinguished from cataract by 
there being no opaque body to be seen behind the pupil ; and by the 
light of a candle appearing discolored, split, or lengthened, or iride- 
scent, whereas in cataract, vision is only clouded, and a lighted candle 
looks as if surrounded with a mist. 

Chances of Cure. — These are generally not very favorable, unless 
the remedies employed very soon produce good effects. 

Treatment. — Electro-galvanism is one of the most promising reme- 
dies. Bayberry root, dried and reduced to an impalpable power, and 
taken as a snuff, is occasionally useful. Cayenne, steeped in water, 
one grain to one ounce of water, and a little of it dropped into the 
eye, may stimulate the palsied nerv^e, and in some cases restore sight 

Blisters may be applied behind the ears, or a seton may be tried 
upon the back of the neck, with some promise of success. 

But probably nothing will do better than cold bathing, — a shower 
bath if it can be borne, — out-door exercise vigorously pursued, and 
an adherence for a long time, — perhaps a year, — to a strictly vege- 
table diet, — at the same time using nervine tonics, etc. (316). 

Short and Long Sight. 

Short Sight, called myopia, depends on too great a convexity of the 
cornea, or crystaline lens, or vitreous humor, — one or all, — and the 
consequent formation of the image of the object inspected a little m 
front of the optic nerve, or retina, — as at a, Fig. 173, instead of at b, 
where it should be formed. The rays of light are brought to a focus 
before they reach the retina. 

Children are either born with this defect, or it is brought on by too 
close study, or by long application of the eyes to minute objects. 



SURGICAL DISEASES. 



485 



It may be remedied frequently by exercising the eyes in looking at 
distant objects. Children afflicted in this way should have their 
studies abridged, and their exercise in the open air increased. While 
studying they 



should have some apparatus applied to them which 
shall keep the chin elevated, so that the head cannot be dropped too 
low, and the eyes brought too near the book. And the book should 



each day be placed a very little further from the eyes. 



Fig. 173. 




Glasses worn by persons having this defect of vision should be 



Lon^ Si;>'lif, or presbyopia^ depends on the humors of the eye not 
being" convex enough. In this case, the image of the inspected object 
is formed beyond the optic nerve^ as at d^ Fig. 174. This is one of the 
earliest signs of advancing age. 



Fio. 174. 




This defect is to be remedied by glasses which are convex^ e. Per- 
son^t in the early autumn of life, must not resort to glasses too hastily, 
or, indeed, until they are compelled to, nor should they change those 
first used too soon. Glasses should make objects look distinct and 
bright, but not larger than natural. 

Squinting. — Strabismus, 

In strabismus, the eyes are not parallel in their position and mo- 
tion. 

It is supposed that one eye may become weaker than the other, or 
that the visual axis of the two may not be adjusted alike, so that one 
eye, — perhaps the more defective one, — turns aside to escape the 
distorted vision, or possibly the injury to itself which would follow 
the attempt to make eyes of unequal power work evenly together. 
The opposing muscles lose their counterbalancing force, and the in- 
ternal rectus, gaining the preponderance, draws the eye inward, — for 
the squint is more often convergent than divergent ; that is, the eye 
turns in more often than out Both eyes sometimes squint. 



486 SURGICAL DISEASES. 



Treatment, — In recent cases, there is some chance of curing this 
complaint without a surgical operation. The patient should not be in 
the society of other squinting persons, so as to learn it by imitation. 

In the first place care should be taken that the bowels are kept in 
good condition, and that the general health is well fortified by bath- 
ing, tonics, and exercise. The patient should be made to stand 
before a glass, and while he closes the sound eye, look steadily at 
some object with the squinting eye. Let him do this till the eye is a 
little tired ; then let him open the sound eye, when the squinting one 
will turn aside. But by compelling it, in this way, several times a 
day, to work in a straight line, it may, perhaps, be taught to remain 
parallel with the other. 

Nervine tonics, as strychnine (86) (94) (95) (316), will sometimes 
do good service ; and electro-galvanism has been found useful in 
many cases. 

But in old and obstinate cases, the only cure is found in dividing 
the muscle which pulls the eye to one side, — the internal rectus, if 
the eye is drawn in, — the external rectus, if it is drawn out. 

Affections of the Ear. 

These are so common, that, in almost every family, they require 
attention, at one time or another. And deafness, which so often 
results from these disorders, is so serious a misfortune, that every 
affection of the ear should receive early attention. 

Examination of the Meatus. — For examining the meatus, or ex- 
ternal passage of the ear, there is perhaps no better instrument than 
a simple silver or glass tube, of the size fio.its. 

and shape represented in Fig. 175. 

To make the examination properly, place 
the patient either in a sitting, kneeling, or 
standing posture, as may be most conven- 
ient, with the ear directly under a good 
stream of gas, or lamp, or sun-light. Then take hold of the ear with 
the thumb and finger, and gently draw it outward and backward, and 
with the other hand introduce the small end of the tube or speculum, 
and carry it forward as far as it will go without producing pain. 
Then by gently swaying the large end of the tube back and forth, a 
stream of light may be made to illuminate all sides of the passage. 
If the lining of this passage is smooth, dry, pearly-white, and shining, 
and is without wax, it may be regarded as healthy. At the close of 
the passage, the tympanum may be seen, and should be semi-trans- 
parent, dry, and grayish-white. Within this, may be seen the handle 
of the malleus, coming from above downward and forward. This 
bone runs about half way across the tympanum, and divides it into an 
upper front, and a lower back part. This lower back portion, when 
viewed through the speculum, is more glistening than the upper and 
front part, and a bright spot of light is seen on its most rounded 
portion, which is just below and behind the point of the malleus. 




SURGICAL DISEASES. 487 



Inflammation causes this innermost part of the meatus to become 
thickened, vascular, or granular, — like the conjunctiva of the eye 
when it is inflamed; it also causes it to secrete and discharge 
matter. 

Inflammation of the Meatus. — Otorrhcea, 

This is quite a common complaint among delicate children ; and 
may occur as the result of scarlet fever, or be excited by currents of 
cold air, by rotten teeth, or by deranged stomach and bowels. 

Symptoms. — Fever, headache, intense pain in the ear, and swelling 
of the glands of the neck. After a time, a reddish, watery discharge 
comes on, which soon grows thicker and mattery. The fever dis- 
appears with the appearance of the thick matter. An examination 
with the speculum shows the whole meatus to be swollen, vascular, 
and covered with a slimy matter. 

Unless great attention be given to cleanliness, the discharge be- 
comes very abundant and fetid, and lasts for a long time ; and if 
neglected, will be likely to lead to very serious consequences, even 
the decay of some of the bones of the head. 

Treatment. — While the inflammation is acute, and there is fever 
and pain, the diet should be confined to mere liquids, — as rice-water, 
gruel, etc., and the bowels should be opened with some preparation of 
salts, — the ear being gently syringed, occasionally, with warm water, 
or decoction of poppies, and being covered with a warm poultice of 
flax-seed, or bread and milk. In place of a poultice, a soft linen bag, 
filled with bran, and dipped in hot water, may be kept on the ear. 
If there be great pain and headache, put leeches behind the ear. 

The pain and fever being gone, and the mattery discharge having 
come on, the case is to be treated like other chronic diseases of mu- 
cous membranes in scrofulous constitutions, by tonics, alteratives, 
warm baths, and out-door exercise. 

The ear may now be gently syringed out with castile soap and 
water, and immediately after with a weak solution of alum, or sul- 
phate of zinc, one grain to a dram. This may be done twice a day. 
Or, a little of a mixture of two drams of solution of sugar of lead 
and half a pint of water, may be dropped into the meatus, and, after 
remaining two or three minutes, be allowed to run out. If the dis- 
charge be very fetid, two drams of solution of chloride of lime, with 
half a pint of water, will make a suitable wash with which to syringe 
it, — applying, once a day, a solution of nitrate of silver, five grains 
to the ounce of water. 

Should the discharge stop at any time, and pain and fever come 
on, lay aside these astringent applications, and go back at once to the 
leeches, purgatives, poultices, and fomentations. 



488 SURGICAL DISEASES. 



Wax in the Ear. 

The ear sometimes becomes completely filled with wax, mixed 
with hairs and flakes of scarf-skin. 

Treatment. — Let the ear be gently syringed from time to time 
with warm soap suds, so as thoroughly to clear out the whole mass 
of matter. The water may be quite warm, and a little cotton should 
be loosely inserted after the syringing. 

Earache. — Otalgia. 

Symptoms. — This is simply neuralgia of the ear, and comes on in 
fits of excruciating pain, which shoots over the head and face. It 
may be distinguished from inflammation of the ear, by the sudden- 
ness and intensity of the pain ; by its not throbbing, not increasing 
in intensity, not being attended by fever, and not coming and going 
without apparent cause. 

Treatment. — Fill or remove all rotten teeth, which may be sus- 
pected as the cause of the suffering. Give iron, particularly the 
citrate combined with strychnine (316). 

Inflammation of the Tympanum.— Deafness. — Otitis, 

Symptoms. — In the acute form of the disease, there is violent pain, 
ringing noises in the ear, and delirium. When the suppuration takes 
place, there is a chill, and a heavy, tensive pain. 

In the chronic form of the complaint, the lining membrane of the 
tympanic cavity, has its vessels a little enlarged, with blood some- 
times effused into its substance, or lymph upon its surface, or the 
membrane is thickened, and sometimes covered with tuberculous 
concretions, or there are fibrous bands occupying nearly the whole 
of the cavity. 

Symptoms. — These are slight, — the first perceptible change being, 
generally, deafness in one or both ears. There may be a woolly sen- 
sation, with noises or ringing, and slight aching pains. 

Treatment. — As the deafness in these cases generally depends on a 
chronic inflammation of the tympanic membrane, the best remedies are 
those which improve the condition of the digestive organs and gen- 
eral health, as regular diet, bathing, pure air, and exercise, with tonics 
and alteratives. Occasionally, a leech or two, or a blister behind the 
ear, will be serviceable. But generally dry cupping behind and in 
front of the ear will answer the purpose for calling the blood away 
from the thickened membrane. 

If the inflammation be acute, it must be combatted with purging, 
blisters, poultices, and fomentations. 



SURGICAL DISEASES. 489 



When deafness is caused by inflammation in the eustachian tubes, 
or from enlargement of the tonsils, etc., the tonsils must be cut off, 
and a solution of nitrate of silver, twenty grains to the ounce, must 
be thrown upon the mouths of the tubes with a shower syringe. 

Bleeding from the Nose. — Epistaxis, 

Treatment. — In full-blooded persons, with redness of face, and sub- 
ject to headache, and dizziness, bleeding from the nose may be salu- 
tary, and necessary to ward off apoplexy, and should not be too sud- 
denly stopped. 

\Vhen the bleeding is such as to require to have it arrested, plug 
the nostrils with the scraping from a fur hat, or with lint, dipped in a 
strong solution of alum, or tannin, or Monsei's persalt of iron, one 
part to ten parts of water. 

Ingrowing Toe-Nail. 

To most persons, the above words will suggest some unpleasant 
associations, for there are few but have had some painful experience 
with this affection. It is generally, like corns and some other trouble- 
some things, the penalty inflicted for wearing tight shoes. It gener- 
ally appears upon the great toe. The constant pressure of a narrow 
boot or shoe against the side of the toe, causes the edge of the nail 
to sink into the flesh, and cause inflammation and pain, and finally 
ulceration. Nature, attempting to repair the mis- -^^^ ^^g 

chief, sends out granulations, which, being perpet- 
ually irritated, shoot up into unhealthy growths, 
called proud flesh. Thenceforward, the sufferings 
of the patient become incessant ; and he cannot 
now even compromise, as he would be glad to do, 
by putting on shoes of ample dimensions, but is 
obliged to negotiate a peace by putting away the 
shoe altogether, or by cutting a hole through it to 
take off the pressure. At ,the risk of giving the 
reader a few dismal twinges every time he looks 
upon this page, we place here, in Fig. 176, a good 
representation of this tormenting disorder, as a 
suitable warning against the folly of giving the toes narrow quarters. 

Treatment. — Make a lye by putting half a pint of hard-wood ashes 
into a quart of hot water ; bathe the toe in this, while warm, twenty 
minutes, every day. Immediately after each bathing apply a poultice, 
made of ground slippery elm and weak lye, changing the poultice 
twice a day. As fast as the inflammation is subdued by this, press a 
little fine lint gently under the edge of the nail. At each subsequent 
dressing, cut off as much of the nail as is raised out of the tender 
flesh, with the keen point of a penknife. Continue to do this till the 
whole offending portion is cut away. 

K the above treatment does not reduce the inflammation and great 

62 




490 SURGICAL DISEASES. 



tenderness, spread some extract of belladonna upon lint, — lay this 
upon the diseased part, and put a poultice over it. 

When the disorder begins to make its appearance, it is a good plan 
to scrape the nail very thin on top ; this will cause it to grow upon 
the upper surface, and to give way at the tender part, so as to obvi- 
ate, sometimes, the necessity of any other treatment. 

The following is the best treatment. Wash the toe in warm water, 
and make the parts dry with cotton wool. Then gently press cotton 
wool in between the toe nail and the tender projecting flesh, and ex- 
tend it along the groove back between the skin and nail. Next, wet 
the end of a piece of nitrate of silver, and rub it thoroughly upon the 
nail, close to the cotton, not allowing it to touch the tender flesh ; 
then put on a thin layer of cotton wool, and, in two or three hours, a 
poultice around the toe. 

In two days, the nail will be perfectly black, and, as far as the ni- 
trate was well applied, will be separated from the parts underneath, and 
may be taken ofl" without pain. 

If the nail is very thick^ scrape ofl* the black and deadened part in 
two days, and apply the nitrate again. This treatment is a vast im- 
provement on the old and cruel practice of tearing off* the live nail. 

Chafing and Excoriation. 

When the neck, arm-pits, thighs, etc., of children, get chafed or 
excoriated, a remedy may be found by keeping the parts clean, and 
by dusting them with powdered slippery elm, starch, or hair-powder. 
If this does not effect a cure, apply Turner's cerate, or wash the parts 
with a solution of sulphate of zinc, or nitrate of silver, five grains to 
the ounce of soft water. 

Grown persons may treat these troubles very much in the same 
way, or by wearing cotton between parts which rub together. 

Foreign Substances in the Nose. 

When any foreign substance gets lodged in the nose, close the 
mouth and the opposite nostril, and then blow forcibly through the 
obstructed side. If this is not successful, press the thumb against the 
nose above the obstructing body, and then make a hook of a piece 
of wire or knitting needle, and pressing it up over the oflending sub- 
stance, pull it down. 

Foreign Substances in the Ear. 

If flies and other insects get into the ear, fill the ear with sweet 
oil, and then syringe it out with warm water. Sometimes it will be 
sufiicient to hold the head down on one side, and have the ear filled 
with water, — remaining quiet in this position for a short time, when 
the insect will rise to the surface. If any hard substance be got into 
the ear, lie down quietly upon the affected side, and send for a phy- 
sician. 



SURGICAL DISEASES. 491 



Foreign Substances in the Gullet. 

If the substance have not gone beyond the reach of the thumb and 
finger, thrust them down as far as possible, and try to pull it out ; or, 
a small curved pair of forceps will reach still lower than the fingers. 
Or, this failing, let some one place one hand firmly on the chest of 
the choking person, and give him a smart blow or two between the 
shoulders with the other hand. If the substance be down some way 
in the gullet, it may be pushed along intq the stomach by some 
smooth, blunt instrument. 

Foreign Bodies in the Windpipe. 

Sometimes foreign bodies will remain a long time in the windpipe, 
and will only create some inflammation and cough, but not any im- 
mediately dangerous symptoms. When the body has gone entirely 
below the epiglottis, but little can be done, except to give a pinch of 
snufl* to cause sneezing, and to direct the patient to expel the air ex- 
plosively from the lungs by a few energetic and sudden coughs. This 
may drive the offending body out. 

Bleeding from Wounds. 

If bleeding occur from any part where a bone lies near the surface, 
as the head or face, it may generally be stopped by pressing firmly 
against the bone with a finger, or a piece of cork, or by binding on 
tightly a hard pad. If this does not succeed, lift up each edge of the 
wound, and examine carefully to see if any small stream of blood is 
spouting out in jets. If so, an artery is wounded, and the point of 
small forceps or tweezers must be dipped in where the jets come 
from ; the spouting mouth taken hold of and drawn out ; and a 
strong silk thread passed around it, and tied below the forceps. The 
white and gaping mouth of the vessel may then be seen. 

If the bleeding be profuse from an arm, the whole current of blood 
to that limb must be cut off*, which may be done by some person 
pressing a thumb firmly into the neck behind the middle of the collar- 
bone. This will dam up the blood in the great artery of the arm, as 
it comes out of the chest. The handle of a door-key, wrapped in 
several folds of linen, may be pressed upon this place for a long time 
until medical assistance can be had. 

Dangerous bleeding from the thigh or leg, may often be stopped by 
pressing the great artery just below the crease of the groin. 

If the bleeding be below the middle of the upper arm, or middle 
of the thigh, pass a handkerchief once or twice around the limb, as 
far above the wound as possible, and tie it tightly. Slip a stiff stick 
under this, and turn it round, like the handle of an auger, until the 
handkerchief becomes so tight as to stop the bleeding. This arrange- 
ment is called a stick-tourniquet, and is intended to answer the same 
purpose with the instrument represented by Fig. 146. 



492 SURGICAL DISEASES. 



Apparent Death from Noxious Vapors. 

When persons become insensible from breathing foul air in a deep 
well or other place where it collects, let them be immediately exposed 
to the open air, and cold water be sprinkled upon the face and head, 
and strong vinegar be rubbed about the nostrils. As soon as there is 
ability to swallow, give some drinks, as lemonade, or a few drops of 
aromatic sulphuric acid, dropped into a tumblerful of water, and 
slightly sweetened. A stimulating injection (246) may be given. 

Apparent Death from Burning Charcoal. 

Some persons very thoughtlessly attempt to warm their sleeping or 
sitting rooms with a portable furnace, or open pan filled with burning 
charcoal, or live coals from a wood fire. This is very wrong, as such 
coals while burning throw off large quantities of carbonic acid gas, a 
deadly poison. This being heavier than atmospheric air, falls to the 
bottom of the room, and for a time may do no damage ; but, if there 
be no chimney-draught, or open door or window, it will rise above 
the heads of those in the room, and bring on asphyxia and death. 

Let such cases be treated the same as the preceding, with the addi- 
tional measure of attempting to excite breathing, as in the case of 
persons apparently dead from drowning. 

To Recover Persons Apparently Drowned. 

Drowning persons die by what is called asphyxia. The air being 
shut off from the lungs, breathing stops, and the immediate accumu- 
lation of carbonic acid in the blood, paralyzes the nervous system, and 
insensibility immediately follows. The heart continues to beat, how- 
ever, from five to twenty minutes after the occurrence of insensibility 
and apparent death. 

Recovery may take place at any time before the heart ceases to 
beat, and has been brought about in some cases even after this organ 
has become still. It has taken place, in some few instances, as late as 
half an hour after being under water, but it can scarcely be expected, 
even under the best treatment, later than twenty minutes from the 
time of submersion ; and even as late as this, the chances are much 
against restoration. 

Treatment. — The best treatment is that recommended by Dr. Mar- 
shall Hall. 

Treat the patient instantly, on the spot, in the open air, and, except 
in severe weather, expose the face and chest to the breeze. 

Then, to Clear the Throat, place the patient gently on the face, with 
one wrist under the forehead. All the fluids, and the tongue now 
fall forward, leaving the passage to the windpipe free. If there be 
breathing, wait and watch. If there be no breathing, or, if there have 
been, and it has failed, 



SURGICAL DISEASES. 493 



Then, to Excite Breathin«:, turn the patient well and instantly on 
his side, and excite the nostrils with snuff, or the throat with a feather, 
and dash cold water on the face, previously rubbed warm. If there 
be no success, lose not a moment, but, instantly, 

^'ext, to Imitato Breathing, replace the patient on his face, raising 
and supporting the chest well on a folded coat or other article of 
dress. Now very gently turn the body on the side, and a little be- 
yond, and then quickly back upon the face, and repeat these turnings, 
back and forth, deliberately, efficiently, and perseveringly, fifteen times 
in a minute, occasionally varying the side. These motions will cause 
a kind of artificial breathing; for while the patient rests upon the 
breast, the weight of the body compresses this cavity, and expels the 
air, w^hich is the same as the outgoing breath, or expiration ; when 
he is turned on the side, the pressure is removed, and the air rushes 
in as in natural inspiration, or the ingoing of the breath. When the 
patient is on the face, make even and efficient pressure along up the 
back of the chest, discontinuing it immediately before turning the 
body upon the side. This upward gliding pressure helps expel the 
air. Of course it must be stopped the moment the body is in a posi- 
tion upon the side to let it in. The result of these movements is 
breathing.^ and, if not too late, life. 

Then, to Induce Circulation and Warmth, rub the limbs upwards 
(and of course this should be done during the previous measures) 
with firm grasping pressure, and with energy, using handkerchiefs, 
and warm soft flannels if at hand. This pushes the blood along up 
towards the heart through the veins. In this way, too, the limbs are 
warmed and dried, and may be now clothed, — the bystanders sup- 
plying the garments. Avoid the continuous warm bath, and the 
position on or inclined to the back. Beside the above, pour into the 
nostrils a teaspoonful of aromatic spirit of ammonia, and thrust a 
feather into the nostrils, dipped in water of ammonia. Give also a 
stimulating injection, composed of a pint of water 'with a tablespoon- 
ful of ground mustard, and a teaspoonful of pulverized cayenne, and 
put a mustard poultice upon the perineum and anus. 

Apparent Death from Lightning. 

A STROKE of lightning will frequently produce asphyxia by par- 
alyzing the muscles of respiration. In such case, the same means 
for recovery should be used as in apparent death from drowning. Or, 
the apparently dead person may be placed in a current of fresh air, 
and cold water dashed upon the face, neck, and breast, and warm 
.friction be applied if the body is cold. 

Apparent Death from Hanging. 

Persons found hanging, who have committed suicide, are to be cut 
down instantly, and the same means employed to reestablish breath- 



494 SURGICAL DISEASES. 



ing as in cases of drowning. It may help to restore the breathing, to 
bathe the forehead and face with vinegar, or tincture of camphor, and 
to pass hartshorn frequently under the nostrils. 

Clothes Catching Fire. 

It is perhaps unreasonable to .look for presence of mind when this 
frightful accident occurs, yet it is never more needed than at such a 
time. 

The instant a lady perceives her clothes to be on fire, and in a blaze, 
she should seize the nearest large rug, cloak, blanket, coverlet, or any 
equivalent article, and, wrapping 'it tight around her, throw herself 
flat upon the floor, taking care to keep the protecting covering close 
to her until the fire is completely smothered. If she does this with 
energy, and effectually, she will put out the fire instantly. 

If she continue on her feet, the blaze will rapidly ascend, and burn 
her vital parts. If she run to seek relief from others not present, the 
motion of the air will fan the flame into a swifter work of destruc- 
tion. 

If it be a child that is on fire, let any person present treat it as 
above. If it be badly burned before the fire is extinguished, put it 
instantly into a tub of cold water, or dash cold water upon it, to 
prevent the burn from becoming deep. 

Accidents on the Water. 

If upset in a boat, or otherwise thrown into the water, and are not 
able to swim, draw the breath in well, and keep the mouth shut tight. 
Do not struggle and throw the arms up ; but yield quietly to the 
water, hold the head well up, and stretch out the hands only below 
the water. To throw the hands or the feet up, will pitch the head 
down, and cause the whole person to go immediately under water. 
Keep the head above, and everything else under water. 

Poisoning Accidents.— Antidotes of Poisons. 

Accidents from poisons are of such common occurrence, that 
every person should know the proper remedies, and not be obliged to 
wait the arrival of a physician before the proper corrective is applied. 
The most common remedies, with the methods of applying them, 
will be given under the proper heads below. The mineral poisons 
will be spoken of first. 

Poisoning by Ammonia. 

Water of ammonia, or hartshorn, if taken in an undiluted state, 
acts as a violent poison. 

When this accident happens, give vinegar instantly, mixed with a 
little water. Vinegar is an acid, and ammonia is an alkali ; and acids 
and alkalies neutralize each other. 



SURGICAL DISEASES. 495 



Poisoning by Antimony. 

Tartar emetic, and wine of antimony, are sometimes taken by 
accident in large doses, so as to act as poisons, and cause dangerous 
vomiting and prostration. 

Give a tea of slippery elm, flax-seed, marshmallow, etc. ; also syrup 
of poppies, paragoric, or laudanum in twenty-drop doses. To neu- 
tralize the poison, give a strong solution of tannin, or an infusion of 
oak bark, or nutgalls. 

Poisoning by Arsenic. 

Use the stomach pump instantly, if one is to be had ; if not, give 
twenty grains of sulphate of zinc (white vitriol) in a little warm 
water; and promote the vomiting by filling the stomach with large 
draught-s of warm or cold milk, sweetened water, or flax-seed tea. 
Or, vomiting may be induced still more quickly, by giving a large 
tablespoonful of strong ground-mustard, mixed with a teacupful of 
water. 

But the best antidote for arsenic is hydrated sesquioxide of iron. 
Mix a tablespoonful of this with water, and give this amount every 
five or ten minutes, until half a dozen doses are taken. 

Treat the inflammation of the stomach which follows, by blisters, 
a bland liquid diet, mucilaginous drinks, etc. 

Poisoning by Verdigris, or Acetate of Copper. 

Cooking utensils made of copper never ought to be tolerated ; yet 
they are used ; and it is from the verdigris which forms upon them 
that most of the cases of poisoning by copper happen. 

Give an emetic instantly, and then two teaspoonfuls of carbonate 
of soda (bread soda) in a tumblerful of water, to be repeated in ten 
minutes. White of eggs, diffused in water, and mucilaginous drinks 
are proper. 

Poisoning by Corrosive Sublimate. 

This is the common bed-bug poison, and is often taken by 
mistake. 

Mix up quickly the whites of a dozen eggs, with two pints of cold 
water, and give a glassful of the mixture every two minutes till the 
stomach can contain no more. If there are not eggs enough at hand, 
take what there are, and make up the deficiency with milk. Wheat 
flour, mixed with water, is a good remedy. Use the stomach pump, 
if it is at hand. Treat the resulting inflammation with leeches and 
fomentations. 



496 SURGICAL DISEASES. 



Poisoning by Sugar of Lead, or Acetate of Lead. 

Give a ground-mustard, or a sulphate of zinc emetic ; then, give 
diluted sulphuric acid, or, either epsom or glauber's salts. 

Poisoning by Strong Lye. 

Strong lye is sometimes swallowed by children. The remedy is 
vinegar, or oil. Vinegar will convert the lye into acetate of potash, 
and any of the oils will unite with it, and form soap; and neither 
the acetate of potasli, nor soap, will materially injure the stomach. 

Poisoning by Nitric, Muriatic, or Sulphuric Acid. 

When either one of these acids is swallowed, not a moment of 
time is to be lost. Fill the patient full of calcined magnesia stirred 
up in water. This is the best remedy; but if it is not to be had, 
give half an ounce of soap in a pint of water. If neither are at 
hand, give chalk, or whiting, in water, or even pound fine some of the 
plastering of the room, and give it in water. 

Poisoning by Nitrate of Potash, called Nitre, or Saltpetre. 

Induce vomiting by luke-warm water, and by tickling the throat 
with a feather; but avoid irritating the stomach with the ordinary 
emetics. 

Poisoning by White Vitriol. 

Provoke vomiting by warm drinks, and by tickling the throat, and 
give freely carbonate of soda, in water. 

Poisoning by Oxalic Acid. 

This resembles epsom salts, and is liable to be taken for salts by 
mistake. The two can always be distinguished by touching a little 
to the tongue. Epsom salts taste hitter ; oxalic acid, very sour. 

In cases of poison from oxalic acid, give magnesia in water as 
quickly as possible. When this is not at hand, give chalk, or lime, 
or saleratus. Use the stomach pump, if it is to be had. 

Vegetable Poisons. 

The vegetable poisons are quite numerous, and many of them 
quite as virulent and rapid as any in the mineral kingdom. 



1 1 SURGICAL DISEASES. 497 



Poisoning by Aconite. 

Give an emetic of ground-mustard or sulphate of zinc, or use the 
stomach pump, instantly, and then give stimulants, as brandy, gin, 
whiskey, rum, etc. 

Poisoning by Opium, Morphine, and Laudanum. 

Use the stomach pump, if at hand ; if not, a powerful emetic of 
sulphate of zinc, or sulphate of copper ; or, if these are not at hand, 
a tablespoon ful of ground-mustard in a teacupful of warm water. 
If vomiting is not induced at once, tickle the throat with a feather, or 
with the finger. If sleep is impending, take the patient into the open 
air, and keep him walking; dash water upon his face, etc. If he 
still falls into sleep, and appears to be near dying, apply means for 
artificial breathing as for persons apparently dead from drowning. 

Poisoning from Belladonna, Hyoscyamus, Stramo- 
nium, and Conium. 

These are all narcotics, and when accidentally taken in poisonous 
doses, the treatment is to be the same as for poisoning by opium. 
Strong coffee is said to counteract the effect of these articles. 

Poisoning by Dogwood, Ivy, etc. 

Give some of the salts as a cathartic, and apply a solution of sugar 
of lead, or, still better, a decoction of witch hazel bark. 

Poisoning by Spanish Plies. 

Give large draughts of sweet oil, sugar and water, milk, or flax- 
seed tea. For the iaflammation of the bladder, which is produced 
by it, apply leeches, and a liniment composed of camphor and sweet 
oil. To relieve the strangury or scalding of the water, give camphor 
internally. 

Poisoning by Prussic Acid. 

This is the most deadly of all known poisons. One drop of the 
pure acid will cause immediate death. Give water of ammonia or 
hartshorn, one part diluted with six parts of water, freely. 

Poisoning by Strychnine. 

The same treatment as for poisoning by opium, excepting that 
sweet milk should be freely administered. This has been recom- 

63 



498 SURGICAL DISEASES. 



mended by one respectable physician, at least, who says he has found 
it to be a specific. Camphor, two ounces dissolved in a quart of 
whiskey, and giwen freely^ is also said to be an antidote. 

Care of the Teeth. 

A DECAY and loss of the teeth is common even among the young. 
Few persons at the age of twenty have sound teeth. 

Rotting of the Teeth. — Caries. 

This is not confined to any age, temperament, or condition of 
society. 

The teeth become diseased, die, and drop away, while all the other 
organs are sound and active. 

The Creator doubtless intended that all the members of the same 
body should be equally durable ; but certain laws of nature, violated 
by us habitually, turn upon us, as it were, in anger, and smite us full 
in the face, breaking our teeth, and robbing us of the means of pre- 
serving the health which we do not appear to prize. 

When rotting begins in the teeth, its progress is more or less rapid, 
and their destruction is certain, unless it is arrested by artificial 
means. 

The enamel is nature^s fortification to protect the teeth against ex- 
ternal injuries. When this is broken, or worn away, the bone of the 
tooth becomes exposed, and rotting begins immediately. Whatever 
has a tendency to crack, break up, or destroy the enamel, therefore, is 
to be carefully avoided. 

Hot Drinks, or hot food, coming suddenly in contact with the en- 
amel, are liable to crack it, and expose the bony substance of the 
tooth. The enamel is exceedingly brittle, much like glass in its struc- 
ture, and is easily cracked when exposed to sudden transitions from 
heat to cold, and from cold to heat. 

Luxurious Living often deranges the general health, and causes 
acid and unhealthy secretions in the mouth, which act injuriously 
upon the enamel. 

Acids are injurious to the enamel ; and when taken as medicine, 
should be well diluted, and in some cases, drank through a tube, so 
as not to come in contact with the teeth. Sugar is not directly inju- 
rious to the teeth, as many suppose ; but if allowed to reman about 
and between them, it may generate an acid which is destructive to 
the enamel. 

A Crowded Condition of the teeth in the mouth causes the enamel 
to wear away, and leads to rotting; in which case, early attention 
and advice from a dentist, is quite important. 

Food Lodged Between the Teeth, and in their depressions, is a cause 
of extensive decay. Animal and vegetable matter, when exposed to 



SURGICAL DISEASES. 499 



warmth and moisture, soon generate an acid which corrodes the en- 
amel. The teeth, consequently, often begin to decay in parts where 
one presses upon an other, and in depressions, where food lodges and 
remains. This shows the necessity of cleansing the mouth and teeth 
often, — particularly after meals. j 

Merciiry, when taken to the extent of salivation, — whether it be 
calomel, corrosive sublimate, blue pill, or any other form of it, — 
causes inflammation of the membranes about the teeth, and indi- 
rectly produces caries. 

Acidity of the stomach, the contact of decaying teeth and dead 
stumps with sound ones, diseased and ulcerated gums, and, above 
all, a filthy, unclean, and unwholesome condition of the mouth, are 
active causes of diseased teeth. 

Improper Tooth Powders, as those containing gritty particles, are 
to be avoided. 

Tobacco, by deranging the general health, may be indirectly inju- 
rious to the teeth. Smoking blackens the teeth ; and though chewing 
may be useful in deadening the sensibility of the nerve of a decaying 
tooth, this alone is not a sufficient reason for so uncleanly and disa- 
greeable a habit, while so many agents may be found to produce the 
same effect. 

Tartar, — This is derived from the saliva, and is found, when ex- 
amined by the microscope, to be composed of myriads of living 
animals. When first deposited around the teeth, it is in a soft state ; 
but, when not brushed away, it soon hardens, and changes from a 
yellow to a brown, and sometimes to a black color; and often in 
children, it becomes a dark green. It destroys the beauty of the 
teeth, giving them a filthy and revolting look ; the setting of the 
teeth in their sockets is weakened ; their appearance is elongated ; 
the periosteum or covering of the fang becomes inflamed and tender ; 
and, if the proper remedy be not applied, the teeth will become loos- 
ened, and finally fall from their sockets. It causes the gums to be- 
come inflamed, swollen, tender, and ulcerated, and loads the breath 
with a disagreeable fetor. Its direct influence on the teeth is not 
great ; but it vitiates all the secretions of the rriouth, and is thus a 
very efficient, though an indirect cause of decaying teeth. In all 
cases, it should be immediately and carefully removed, and some 
astringent wash, made from peruvian or oak bark, be applied to 
reduce the inflammation and swelling of the gums. 

Tooth-Ache. 

This is generally caused by an exposure of the nerve which fills 
the internal cavity of the tooth. This exposure is caused by a frac- 
ture, or, more commonly, by the rotting away of a part of the tooth. 
This nerve is extremely sensitive ; and, by coming in contact with 
the air and acrimonious substances, inflammation is excited, and 
tooth-ache is the consequence. 



500 SURGICAL DISEASES. 



Teeth sometimes ache when they are, to appearance, perfectly- 
sound. This may be caused by bony enlargements of the ends of 
the fangs, inflammation of the periosteum, a peculiar irritability and 
ague of the face, which excite neuralgia, etc. 

Pain of a sound tooth is sometimes caused by sympathy with a 
decaying one, by a disordered stomach, or by scurvy, pregnancy, tar- 
tar, or whatever excites painful sympathetic action in the nerves of 
the face. 

Treatment. — Tooth-ache may be quieted by placing a drop of oil 
of cloves, or cajeput, or a drop of creosote upon a piece of cotton, 
and inserting it into the cavity of the tooth, and bringing it into con- 
tact with the exposed nerve. 

Pains of the face and jaw, when not the consequence of rotten 
teeth, may be relieved by holding brandy, or whiskey, or rum, or 
diluted tincture of cayenne, or hot water, in the mouth, and by ex- 
ternal applications of laudanum, Oliver's plaster, a mustard plaster, 
or hops steeped in alcohol, or a blister behind the ear. But for teeth 
too much decayed to be saved by filling, there is no remedy so proper 
as extraction. 

Filling Teeth. 

There is no operation of the dentist of more real and lasting 
benefit to the patient than that of filling rotten teeth. 

A tooth that is well filled before its nerve is exposed, is as servicea- 
ble as a sound one, and nearly as durable. Its preservation for many 
years is perfect and complete. 

It is necessary, in the performance of this operation, to remove 
very carefully all rotten and foreign matter lodged in the cavity ; to 
make the cavity of a dovetail shape, so as to retain the filling ; to wipe 
it perfectly dry ; and to press the gold in so as to make the cavity 
perfectly water and air tight. A tooth filled in this way may be pre- 
served many years, and in many cases, during life. 

"When decay has gone so far as to expose the nerve and render a 
tooth painful, the nerve, in all cases, should be destroyed before the 
cavity is filled ; otherwise there may be soreness, and sometimes ex- 
treme pain, making the extraction of the tooth absolutely necessary. 

A tooth filled after the nerve is destroyed is not as good as if filled 
before the nerve was exposed ; the walls of the cavity are thinner and 
weaker, and consequently are more liable to break and crumble away 
when brought into contact with hard substances ; and the filling will 
be more likely to be loosened. There is likewise some danger of 
ulceration and absorption at the root of a tooth, when filled in this 
condition, which makes it very important that teeth should be filled 
early. 

Gold foil is preferable to all other substances for filling teeth. If it 
is properly pressed and polished, it will remain in the mouth for many 
years without any sensible loss of its substance. 



SURGICAL DISEASES. 501 



The First Teeth. 

It is an imperative duty of parents to see that their children's teeth 
have early and careful attention. 

The health and durability of the permanent teeth depend materi- 
ally on the healthy condition, regularity, and durability of the tempo- 
rary ones. It may seem strange that diseases of the first set of teeth 
should influence the set which is to follow; but when we consider that 
the rudiments of the second set already exist when the first are cut, 
it is not unreasonable to suppose they may inherit disease from their 
predecessors. 

Cleaning the Teeth. 

The most important rule to be observed in the preservation of the 
teeth, is to keep them perfectly clean, and never to allow any foreign 
substance to remain on or about them. A decaying tooth should 
never be allowed to remain in the mouth ; it causes others to decay. 

If tartar have been allowed to collect, have it removed immedi- 
ately. The teeth should be carefully and thoroughly brushed daily 
with warm water, and the occasional use of a detifrice that is impal- 
pably fine, and that contains no acid. 

A Brush has no bad effect upon the teeth, as some suppose, for the 
parts of the teeth most exposed to the friction of a brush are never 
the first to begin to decay. This beginning of decay takes place in 
their depressed surfaces, and where they touch each other. A soft 
brush is better for the teeth than a stiff one, because the latter is 
apt to fret the gums, and cause them to recede, which gives the 
teeth a lengthened appearance. 

Teeth in a crowded condition should never be filed, unless they 
begin to decay. 

Tooth-Picks, made of quill, or wood, or ivory, should be used after 
meals, and all particles of food lodged between the teeth should be 
removed. 

In Sickness, the rules for cleanliness of the teeth should be more 
rigidly enforced than at any other time, as then they are more ex- 
posed to destructive agents, and are liable to participate in the gen- 
eral debility and disease of the system. 



Influence of Diseased Teeth upon the Health. 

The bad effects of a diseased and unclean mouth upon the general 
health, are of more serious consequence than most people are aware. 
In twenty-four hours, we breathe twenty thousand times ; and what 
must be the effect upon the delicate structure of the lungs, when, for 
days, months and years, the air we breathe is drawn through a depos- 



502 SURGICAL DISEASES. 



itory of filth, and is poisoned by being mixed with effluvia arising 
from decayed and diseased matter in the mouth. 

The intermittent fevers of the West are caused by the effluvia aris- 
ing from the decaying matter of low grounds and marshes, which 
can hardly be more pernicious than the effluvia from the impurity 
and corruption generated in an unclean mouth, filled with decaying 
teeth. Dr. Hays says " no species of animal matter is so offensive to 
the health and vitality of the adjoining substance, whether nerve, or 
membrane, or any part or portion of the living body, as decaying 
bone." 

Fumigation of Infected Chambers and Other Places. 

Xitric Acid Fumigation. — The efficiency of nitric acid in the form 
of gas, in arresting contagion, and in cleansing infected rooms, ships, 
and other places, is well established. To obtain the gas, pour one 
ounce of sulphuric acid upon two ounces of nitrate of potash in a 
large tea cup, — the cup being placed in a basin containing hot water. 
The gas or vapor will be immediately disengaged. 

This quantity will thoroughly cleanse a small apartment, but if 
used in a sick room, should be placed at some distance from the 
patient. In a large room, two cups will be required ; and if a whole 
house is to be fumigated, let several be placed in various apartments, 
and the doors and windows be closed for half an hour. 

Cliloride of Zinc. — A solution of the chloride of zinc has great 
power in arresting contagion, and in cleansing infected places. A 
small quantity of it will, in a few minutes, cleanse the most offensive 
apartments. 

Chloride of Lime. — This is one of the most powerful disinfecting 
or cleansing agents known. To prepare it for use, add four gallons 
of water to a pound of the chloride of lime ; stir the mixture well, 
and after aUowing it to settle for a short time, pour off the qlear 
solution, and keep it in well-corked bottles. 

• 

Chloride of Soda. — This, in disinfecting power, is about equal to 
the chloride of lime. In order that it may retain its properties, it 
must be kept from the light, in a well-stopped glass bottle. When 
used, it must be mixed in the proportion of one ounce, or two large 
spoonfuls, to the pint of water. It is excellent for cleansing car- 
buncles, gangrenous sores, bad ulcers, ulcerated sore throat, and fetid 
discharges of every kind. A weak solution should be frequently ap- 
plied. 

Uses of Chlorides of Lime and Soda. — These articles almost in- 
stantly destroy every bad smeU, and all effluvia arising from animal 
and •vegetable decomposition, and entirely prevent their bad influ- 
ence. 

While infectious or contagious diseases prevail in large towns or 
cities, the rooms should be sprinkled, morning and evening, with 



SUliGICAL DISExVSES. 503 



some of one of these solutions. Some of it should be placed in the 
different rooms, in shallow dishes, — the small bed-rooms being par- 
ticularly remembered. 

In houses where there are typhoid and putrid fevers, and infectious 
complaints, it is highly proper to sprinkle the solution about the 
rooms, and occasionally upon the bed-linen ; and the air of the room 
should be frequently renewed. A wineglassful added to the chamber- 
vessel or the bed-pan will prevent all smell. 

Before sending the bed and other linen to the wash, let it be im- 
mersed, five or six minutes, in one of these solutions, diluted, as mere 
washing will not always remove the infection. But the linen should 
be immediately rinsed in pure water after the immersion ; to allow it 
to dry without such rinsing might injure it. 

By pouring a quart of one of these mixtures, added to a pailful of 
water, into drains, sewers, or cesspools, and repeating the application 
as may be required, will destroy all their offensive effluvia. 

Meat, will keep for some time, without any taint, and without the 
molestation of flies, if immersed in one of these solutions for an in- 
stant, and hung up ; and all tainted meat, fish, game, etc., will be 
rendered sweet by a little sprinkling of the same. 

To purify water in cisterns, and destroy the animalcules in it, add 
to every one hundred gallons, about a pint of one of the solutions. 

The washing of bedsteads with one of the solutions, and putting 
it into all the crevices, will destroy bugs. 

A room just painted may be slept in safely, if one of the mixtures 
be sprinkled about, and left in shallow dishes. 

Stables, slaughter-houses, hog-styes, privies, and all places from 
which offensive smells arise, may be thoroughly purified by these 
mixtures. 

Being guardians of the public health of such wide application, and 
of so great utility, it is surprizing that they are not more used. 



Freezing Mixtures, 



n 



In treating wounds, inflammations, etc., it is often quite irtiportant 
to have ice, which is not to be obtained without manufacturing it. 
Accordingly, I give here a few directions for its immediate production. 

The salts used should be in a crystalized state, with as much water 
in them as possible without being damp. They should be coarsely 
pulverized at the time of using, and put into the water contained in 
a basin, or other suitable vessel. The water to be frozen should be 
inclosed in a thin vessel, and immersed in the freezing mixture. To 
obtain extreme degrees of cold, the ingredients and the vessel should 
be cooled by one mixture, before being mixed for another. 

To five drams of pulverized hydrochlorate of ammonia, and five 
drams of pulverized nitrate of potash (nitre), add two ounces of 
water, in a tin, stone-ware, or glass vessel, and you may freeze water, 
sea-water, milk, vinegar, or oil of turpentine. It will cause the ther- 
mometer to sink from 50° above zero, to 10° above ; that is, fortt/ 
decrees. 



O04 SURGICAL DISEASES. 



A mixture of five drams of sulphate of soda, and four drams of 
diluted sulphuric acid, will sink the thermometer seven degrees lower 
than the above, namely, down to 3° above zero, or twenty-nine degrees 
below the freezing point 

If six drams of sulphate of soda, four drams of hydrochlorate of 
ammonia, two drams of nitrate of potash, and four drams of diluted 
nitric acid be put together, the mixture will lower the thermometer 
60° ; that is, to 10° below zero, or 42° below the freezing point. 

Beside the above, the following combinations may be used : 

Muriate of ammonia, five ounces ; nitrate of potash, five ounces ; 
water, sixteen ounces. Mix. 

Nitrate of ammonia, four ounces ; crystalized carbonate of soda, 
four ounces ; water, four ounces. Mix. 

Nitrate of ammonia and water, equal parts. Mix, 

Nitrate of ammonia, and nitrate of potash, five parts each ; sul- 
phate of soda, eight parts ; and water, sixteen parts. Mix. 

Phosphate of soda, nine parts ; diluted nitric acid, four parts. Mix. 

Sulphate of soda, eight parts ; muriatic acid, five parts. Mix. 

Sulphate of soda, six parts ; nitrate of ammonia, five parts ; di- 
luted nitric acid, four parts. Mix. 

Freezing Mixtures with Ice; — Snow or pounded ice, two parts ; 
salt, one part. Mix. This will sink the thermometer to 5° below 
zero. 

Snow or pounded ice, four parts ; salt, two parts ; muriate of am- 
monia, one part. In this mixture the thermometer will go down to 
12° below zero. 

Snow or pounded ice, twenty-four parts ; common salt, ten parts ; 
muriate of ammonia, five parts ; nitrate of potassa, five parts. Mix. 
Gives 18° below zero. 

Snow or pounded ice, twelve parts; common salt, five parts; nitrate 
of ammonia, five parts. Mix. Gives 25° below zero. 

Snow, eight parts; muriatic acid, five parts. Mix. Gives 27° below 
zero. 

Snow, seven parts ; diluted nitric acid, four parts. Mix. Gives 30° 
below zero. 

Snow, four parts ; chloride of calcium, five parts. Mix. Gives 40° 
below zero. 

Snow, three parts ; potassa, four parts. Mix. Gives 51° below 
zero, or 83° below the freezing point. 

Dr. Ira Warren's Paracentesic Instrument. 

Puncturing the chest for drawing off water in extensive pleuritic 
efTusion, as practised of late, has proved one of the most valuable 
operations in modern surgery. Like most new operations, however, 
it has been embarrassed by imperfect instruments. 

The annexed cut represents an improved instrument which I have 
just invented, by which this operation is made extremely simple and 
easy. At the right hand is the puncturing instrument, including the 



SURGICAL DISEASES. 



505 



external canula, and the trochar inserted in it. At the letter i is a slid- 
ing guard which moves back and forth, and may be set at the point of 
desired depth to which it is desirable to puncture, and made fast by 
a screw. By this arrangement it may be driven home to the desired 
depth, without any fear of going too far, or of falling short of the 
mark. The guard also serves in a measure to keep the instrument 
steady during the operation, and to prevent inflicting pain by having 
it oscillate about. At 5 is a tubular attachment, opening into the 
canula ; to this an India-rubber hose is attached, which connects, at 
the other end, with the cock, a, upon the exhausted receiver, o. To a 
cock, c, on the other side of the receiver, another rubber hose is fast- 
ened, which connects at the other end with an air-pump. 

Fig. 177. 




1L 



I 



The mode of operating is exceedingly simple. First, exhaust the 
receiver; then quickly, yet gently, plunge in the instrument, and, leav- 
ing the canula, withdraw the trocar till the point passes the connect- 
ing tube at 6, when the water will immediately flow, in a full stream, 
into the exhausted receiver, o. The working of the apparatus is ex- 
tremely beautiful. Five pints of w^ater may be taken away with it in 
five minutes, — an amount which cannot be got with the old instru- 
ment in much less than half an hour. If the patient cannot bear to 
have it drawn so rapidly, the stream may be wholly or partially ar- 
rested, at any moment, by entirely or partly closing the cock, a. 

The reader will see that the apparatus is so arranged that the ad- 
mission of air into the chest is entirely impossible. 

The artist, in making the drawing for me, has inserted the instru- 
ment much further forward than the point usually selected. 

My apparatus has a second puncturing instrument, a little larger in 
size, for the purpose of operating in ascites, or dropsy of the belly. 

64 



HOMEOPATHIC REMEDIES. 



Though not a believer in the Homceopathic system of practice, or 
in the efficiency of infinitesimal doses, yet I have no prejudices against 
the system ; and I introduce its remedies here as a matter of interest 
to all, and for the gratification of those sincere disciples of its doc- 
trines who (and I hope there will be many of them) may consult 
these pages. Every system which wins to its support numerous, 
sincere, and capable minds, must have a fraction of truth in it, and 
is entitled to a respectful and civil hearing. Whatever the system 
may be, to claim that all its followers are dishonest, and governed by 
bad motives, is to evince both injustice and unreasoning bigotry. 

With these views, I give the remedies used in the Homoeopathic 
practice, not in their fulness of detail, but to such extent as my limits 
will allow. In doing this, I have followed the " Manual of Homoeo- 
pathic Practice," by A. E. Small, M. D., Professor in the Homoeopathic 
Medical College of Pennsylvania. This is one of the clearest and 
best arranged manuals of this practice I have seen, and is now enjoy- 
ing an extensive popularity. 

List of Remedies.— Principle of Applying Them. 

Professor Small says : " The following list comprises all the 
medicines used in this work. It is remarked that every medicine 
has a certain range of action in the body. Some will act upon one 
kind of organs in a particular way, and some on others ; — or some 
medicines will always direct their energies to one locality, and others 
to another ; therefore, it must first be ascertained how a remedy will 
affect the healthy system, and this will determine the locality of its 
action, or in other words, it will manifest the symptoms of its effect ; 
it is the record of these symptoms that gives us an idea of the range 
of a medicine. 

" In the following list, we shall only place such medicines as have 
been thus tried, and their range of use ascertained. 

LIST OF REMEDIES. 

1. Aconltum napellus, 5. Apis melifica, 9. Belladonna, 

2. Alumina, 6. Arnica montana, 10. Bromine, 

3. Ammonium carb., 7. Arse nicimi album, 11. Bryonia alba, 

4. Autimouium crud., 8. Aurum metallicum, 12. Calcarea carb., 



HOMCEOPATHIC REMEDIES. 



507 



13. Cannabis sativa, 

14. Cantharis, 

15. Carbo vegetabilis, 

16. Causticum, 

1 7. Chamomilla, 

18. China officinalis, 

19. Cina, 

20. Cocculus, 

21. Coffea cruda, 

22. Colehicum, 

23. Coloeynthis, 

24. Conium maculatum, 

25. Crocus sativus, 

26. Cuprum metallicum, 

27. Digitalis purpuera, 

28. Drosera rotundifolia, 

29. Dulcamara, 

30. Eupatorium, 

31. Euphrasia off., 

32. Ferrum metallicum, 

33. Graphites, 

34. Helleborus, 



35. Heper sulph. calc, 

36. Hyoscyamus niger, 

37. Hamamelis, 

38. Ignatia amara, 

39. Iodine, 

40. Ipecacuanha, 

41. Kali carbonicum, 

42. Kali bicromicum, 

43. Lachesis, 

44. Lycopodium, 

45. Mercurius subl. corr., 

46. Mercurius vivus, 

47. Mezereum, 

48. Moschus, 

49. Natrum muriaticum, 

50. Nitric acid, 

51. Nux vomica, 

52. Opium, 

53. Petroleum, 

54. Phosphorus, 

55. Phosphoric acid, 

56. Platina, 



57. Pulsatilla, 

58. Rheum, 

59. Rhus toxicodendron, 

60. Ruta graveolens, 

61. Sabina, 

62. Sambucus nigra, 

63. Sanguinaria, 

64. Secale cornutum, 

65. Senega, 

OS. Sepia succus, 

67. Silicia, 

68. Spigelia anthelmin., 

69. Spongia marina tosta, 

70. Stannum, 

71. Staphysagria, 

72. Stramonium, 

73. Sulphur, 

74. Sulphuric acid, 

75. Tartarus emeticus, 

76. Uva ursi, 

77. Veratrum album, 

78. Zincum metallicum. 



79. Arnica, 

80. Calendula, 

81. Cantharis, 



TINCTURES FOR EXTERNAL USE. 



82. Causticum, 

83. Hypericum, 

84. Ruta graveolens, 



85. Stapnysagria, 

86. Urtica urens. 



Medicines the Best Adapted to the Different Temperaments, 

Habits, etc. 

1. For the San^nine Temperament. — Aeon., Am., Bell., Bry., Calc., 
Hep., Merc., Cham., Nux v., Phos., etc. 

2. Bilious Temperament — Bry., Nux v., Ars., Sulph., Merc, Coc- 
culus, etc. 

3. Ner^^ous Temperament. — Sepia, Coff., Platina, Ignatia, Puis., 
Nux v., Cham., etc. 

4. Lymphatic Temperament. — Ant., Arn., Nit. Acid, Calc, Puis., 
Sulph., Con., Clematis. 

5. Melancholic Temperament. — Aurum, Ars., Nux v., Verat., Ipec, 
Chin., etc. 

6. For Plethoric Habit. — Aeon., Bell, Calc, Puis., Merc, Sep., etc 

7. Debilitated Habit. — Ars., Chin., Bry., Lachesis, Arn. 

8. Lean Habit. — Sil, Lach., Graph. 

9. Melancholy Disposition. — Ars., Verat., Aurum, Puis., Aeon., Bry. 

10. Mild Disposition. — Puis., Sep., Calc, Ignag. 

11. Sensitive Disposition — Calc, Ignat., Plat, Bell., Bry., Graph- 
ites. 



508 HOMCEOPATHIC REMEDIES. 



Rules for the Administration and Repetition of Remedies. 

1. In acute diseases, a remedy, if well chosen, may be repeated at 
intervals of one or two hours, until some amelioration or aggravation 
of the malady becomes manifest ; in either case, it would be well to 
discontinue the remedy for a while, to await the result. 

2. If the aggravation is persistent without reaction, there is reason 
for change of remedy, and another should be chosen, according to 
indications. 

3. If convalescence follow the administration of a remedy, it need 
not be repeated unless the patient ceases to improve before he is 
quite recovered ; and the same rule will apply, in cases of ameliora- 
tion, after an aggravation of symptoms. 

4. When the improvement in a patient becomes interrupted, with- 
out a change of symptoms, recourse may be had to the same remedy 
as at first ; but if such arrest is accompanied by a development of 
other symptoms, a more appropriate remedy must be sought for. 

5. In obstinate cases, a change of remedy is admissible, when 
the continuance of one has been so long as to render its action 
doubtful. 

6. In chronic cases, a well-chosen remedy need not be repeated 
oftener than once in one, two, or three days. 

7. In the selection of a remedy, great care should be exercised, that 
no symptoms of the disease should be uncovered by the characteristic 
symptoms of the remedy. 

The Form of Medicines Designed for Domestic Use. 

The only forms, in which homoeopathic medicines are prepared, 
may be comprised under the head of tinctures, triturations, dilutions, 
and globules. The last two are the only forms requisite for general 
use, the two former being only the primary or preparatory stages of 
the two latter. Therefore, either the dilutions^ or globules saturated 
with them, are the only forms of medicines accompanying this work. 

When either of the forms is administered in water, contained in a 
tumbler or other open vessel, it should be well covered between the 
periods of administration, and kept in a dark place, away from any 
corrupting odor; — and all other medicines, teas or odors, are strictly 
^prohibited during its administration. External applications of any- 
thing in the form of poultices, washes, lotions, such as camphor, lini- 
ments, cologne, mustard-plasters, medicated poultices, onions, bur- 
docks, or anything containing any medicinal property whatever, must 
be strictly avoided when taking the medicine. 

Of Preserving the Purity of Medicines. 

1. The medicines should be kept in a chest constructed for the 
purpose. 



HOMCEOPATHIC REMEDIES. 509 

2. The chest should be kept closed, and in a cool place, or if in a 
warm climate, as much so as possible. 

o. In uncorking a phial, be careful to replace the identical cork, or 
a new one, if the first should get broken or unfit for use. 

4. Do not change the corks of different remedies, nor put medicine 
of one kind into a phial that has contained another kind. 

5. It is better to destroy empty phials, than to put any medicine in 
them, other than that which they originally contained. 

6. Every medicine should be carefully labelled or numbered. 

7. Do not prepare a solution without first being assured that the 
glass and spoon are perfectly clean ; and if it be necessary to prepare 
two at a time, use separate spoons for each, and be careful to keep 
them apart. 

Antidotes, and Changing Medicines. 

When any medicine produces aggravation of suffering, that cannot 
well be endured by the patient, the administration of one drop of 
camphor in a spoonful of water, will generally antidote its effect. 
And when it is thought requisite to change a remedy, avoid doing it 
suddenly. A period from two, to four or six hours should elapse, 
before a remedy should follow one that has been given ; a teaspoon- 
ful of coffee, or a few drops of wine, may also be employed as anti- 
dotes to an unfavorable medicinal action. 



External Applications. 

When it is desired to hasten suppuration, a piece of lint saturated 
with cold water, and kept constantly moist, with a dry bandage on the 
outside, so as to exclude the air, will be found one of the simplest and 
best applications that can be used. 

It is doubtful whether cold applications to local irritations or ten- 
sion of parts, are of any use ; warm applications, either of warm 
water or non-medicinal fomentations are better, as they may palliate 
suffering during the administration of internal remedies. Cold appli- 
cations to the head, to counteract heat in that region, more frequently 
prove injurious than beneficial. Moderately hot water, applied by 
means of saturating a flannel, is by far the most preferable. 

The same remedies, prescribed internally for local affections, may 
be applied externally as a lotion, by dissolving them in water, and 
applying them to the affected part. 

Remedies Suitable to Follow Others. 

8. In the treatment of diseases, it has been observed that some 
remedies act very beneficially, after others have been employed, and 
the following list may be referred to as a partial guide ; — only, let it 
be understood, that the remedy must be selected, hymoeopathic to the 
case. 



510 HOMOEOPATHIC REMEDIES. 

AcoxiTUM Napellus, may be often followed by Calc, Petr., Puis., Sulph. 

Alumina, by Bryonia, if indicated. 

Antimoxium Crud., by Puis, and Merc., if either appear to be indicated. 

Arnica Mont., by Aeon., Ipec, Rhus., Sulph., etc., if either be indicated. 

Arsenicum Album, by Chin., Ipec, Nux vom., Sulph., Verat., if specifically in- 
dicated. 

Belladonna, by Chin., Ipec, Hep., Rhus., and Sene^., — either if indicated. 

Bryonia, by Alum, and Rhus., — according to indication. 

Calc. Cars., by Lye, Sil., Phos., and Nit ac, provided any one of them is indi- 
cated. 

Carbo. Veg., by Ars. and Merc, according to indication. 

China Off., by Ars., Verat, and Puis., if suitable. 

Cuprum Met., by Calc. and Verat, ^ " 

Hep. Sulph., by Bell., Merc, and Spong., " 

Ipec, by Am., Ars., Chin., and Nux., " 

Lachesis, by Alum., Ars., Bell., Con., and Nux vom., if suitable. 

Lycopodium, by Graph., Phos., and Sil., " 

Mercurius, by Bell., Dulc, Puis., and Sil., " 

Nux Vom., by Bry., Puis., and Sulph., " 

Opium, by Calc, Petr.. and Puis., " 

Phosphor., by Petr., Rhus., and Sulph., " 

Pulsatilla, by Asa., Bryon., and Sep., " 

Rhus Tox., by Ars., Bry., Calc, Con., «« 

Sepia Sue, by Carbo v., and Sulph., ** 

SiLiCEA, by Hep., Lach., Lye, and Sep., " 

Spongia, by Hep. Sulph., " 

Sulphur, by Aeon., Bell, Calc, and Puis., " 

Tart. Emetic, Ipec, Puis., and Sep., " 

Veratrum Album, Ars., Am., Chin., Cuprum, and Ipec, if suitable. 

Dilutions and Globules being the only forms in which Homoeopathic 
medicines are used in Professor Small's work, he, in most cases, dis- 
solves one drop of the dilution, or six globules, in water, — from two 
tablespoonfuls to half a tumblerful, — and gives from one teaspoonful 
to one tablespoonful of this every one, two, three, or four hours, until 
a change occurs. 

Simple Fever. — Aconitum. 

Inflammatory Fever. — Aconitum, Belladonna, Bryonia, Cantharis, 
Chamomilla. 

Typhoid Fever. — Aeon., Ars., Am., Bell., Bry., Chin., Cocc, Cam ph., 
Calc. c, Carbo. veg., Dig., Hyos., Hellb., Lye, Lack., Nux v.. Nit. acid, 
Nat. Mur., Opium, Puis., Phosph., Phos. acid, Rhus., Stram., Sulph., 
and Verat. 

Bilious Fever,— Remittent Fever. — Aeon., Ars., Bell., Bry., Cham., 
Cocc, Coloc, China, Digitalis, Ipec, Mercurius viv., Nux vom.. Puis., 
Rhus tox.. Tart. emet. 

Intermittent Fever. — Am., Ars., Bell., Bry., Carb. veg., Cham., 
China, Cocc, Ipec, Ign., Merc, Nux. vom., Nat. mur., Opium, Puis., 
Sep., Sulph., Rhus., Veratrum. 

Yellow Fever. — Aeon., Ars., Bell., Bry., Chin., Canth., Carbo. veg., 
Ipec, Lachesis, Mercurius, Nux vom., Rhus., Sulphur, and Veratrum. 

Nettle Rash. — Aeon., Calcarea, Cham., Bryonia, Dulcamara, Ipec, 
Mercurius, Nux vom., Nit. acid, Pulsatilla, Rhus and Sulphur. 



HOMCEOrATHlC REMEDIES. 511 



Scarlet Rash. — Aconite, Belladonna, Bryonia, CoiTea, Ipecac., and 
Opium. 

Scarlet Fever, — Aeon., Arsenicum, Belladonna, Bryonia, Calc. carb., 
Chamomilla, Digitalis, Dulcamara, Helleborus nig., Hepar Sulph., 
Kali carb., Lycopodium, Mercurius, Nitric acid, Nux vom., Opium, 
Phosphorus, Phosph. acid, Pulsatilla, Rhus tox.. Sulphur, Silicea. 

Measles. — Aconite, Arsenicum, Arnica, Belladonna, Bryonia, Cham., 
Calc. c, Carbo. veg., China, Conium, Drosea, Dulcamara, Hyoscyamus, 
Hepar sulph., Ignatia, Ipecac, Lachesis, Mercurius, Nux vom., Phos- 
phorus, Pulsatilla, Sepia, Sulphur. 

Erysipelas. — Aconite, Arsenicum, Belladonna, Bryonia, Lachesis, 
Rhus tox. 

Chicken Poi. — Aconite, Belladonna, Coffea, Cantharides, and Ig- 
natia. 

Varioloid. — The treatment to be the same as for 

Small Pox, for which the remedies are. Aconite, Belladonna, Bryo- 
nia, Chamomilla, Coffea, Opium, Pulsatilla, Rhus tox., Stramonium, 
and Vaccinin. 



Gont. — Aconite, Arnica, Arsenicum, Belladonna, Bryonia, China 
Causticum, Colocynthis, Ferrum, Mercurius, Nux vom., Pulsatilla 
Rhus tox. 



Inflaimnatory Rheumatism, — Aconite, Arnica, Belladonna, Bryo- 
nia, Cham., Chin., Hepar sulph., Lachesis, Mercurius viv., Nux vom., 
Puis., Rhus tox., Sulphur. 

Chronic Rheumatism. — Aconite, Bryonia, Calc. carb., Causticum, 
Dulcamara, Hepar sulph., Lachesis, Lycopodium, Phosphorus, Rhus 
tox.. Sulphur, Silicea, Veratrum. 

Lumbago. — Aconite, Bryonia, Belladonna, Mercurius, Nux vom., 
Pulsatilla, and Rhus tox. 

Sciatica. — Aconite, Chamomilla, Colocynthis, Ignatia, Nux vom., 
and Rhus tox. 

Tooth- Ache. — Aconite, Arnica, Arsenicum, Belladonna, Chamomilla, 
Mercurius, Nux vom., Pulsatilla, Sulphur. 

Inflammation of Tonsils. — Aconite, Belladonna, Bryonia, Canthar- 
ides, Chamomilla, Dulcamara, Hepar sulph., Ignatia, Lachesis, Mer- 
curius viv., Nux vom.. Nitric acid. Sulphur. 

Putrid Sore Throat, — Aconite, Arsenicum, Belladonna, Conium, 
Lachesis, Mercurius, Nitric acid, Pulsatilla, Rhus, Secale, and Sul- 
phur. 

Canker of the Mouth, — Arsenicum, Carbo. veg.. Dulcamara, Hepar 
sulph., Mercurius, Natrum muriaticum, and Sepia. 



512 HOMCEOPATHIC REMEDIES. 

Inflaminatiou of the Tongue. — Aconite, Arnica, Arsenicum, Bella- 
donna, Lachesis, Mercurius, Phosphoric acid. 

Mumps. — Belladonna, Carbo. veg., Hyoscyamus, Mercurius. 

ludig'estion. — Aconite, Ant. Crudum, Arsenicum, Belladonna, Bry- 
onia, Ipecac, Tart, emet, and Veratrum. 

Bilious Headache. — Antimonium crud.. Arnica, Belladonna, Bryo- 
nia, Chamomilla, China, Hepar sulph.. Ipecacuanha, Ignatia, Lachesis, 
Nux vomica, Pulsatilla, Sulphur, Tartar emetic. 

Further indications for the use of remedies in dyspepsia from dif- 
ferent causes, may be found in the following leading considerations : 

When everything taken causes suffering on account of the weakness 
of digestion, Carb. veg., Chin., Nux vom., and Sulph. 

From cold water, if it should be found to disagree, Ars., Cham., 
Chin., Ferrum, Nux vom.. Puis., and Veratrum. 

If caused by beer, Bell., Colocynth., Rhus, and Sep. 

When produced by milk, Bry., Calc, Nux vom., and Sulph. 

From animal food, Ferrum, Ruta, Silicea, and Sulphur. 

mien caused by fat or gravies, Nat. Mur., Puis., Sep., and Sulphur. 

For different ages and constitutions. — Children suffering from dys- 
pepsia require chiefly Calc, Ipecac, Nux vom., Hyos., and Sulphur, 
according as the symptoms may indicate. Old people require Cicut£i, 
Ant. cr., Carbo veg., China, and Nux vom. 

Hypochondriacal persons require for the most part Nux vom. and 
Sulphur. 

Hysterical females require Puis., Sep., Sulph., Veratrum "and others. 

IMien brought on by sedentary habits, Bry., Calc, Nux vom., Sep., 
Sulphur. 

When by prolonged watching, Arn., Carb. veg., Cocc, Nux vom.. 
Puis., Verat. 

When by excessive study, Arn., Calc, L'^chesis, Nux vom., Puis., 
and Sulphur. ^ 

WJien by debilitating losses, as in diarrhoea, dysentery, vomiting or 
bleeding, China, Ferrum. 

When by sexual excesses, Calc, Merc, Nux vom., Phos. ac, Staphy- 
sagria. 

When the disease is in persons of the lymphatic temperamentj Chin., 
Puis., Sulph. 

When in persons of sanguine temperament, Bry., Nux vom.. Bell., 
Phos. 

When in persons of bilious temperament, Cham., Cocculus, China, 
Sulph. 

When in those of melancholic temperament, Aunim, Ars., Nux vom.. 
Puis., Sep. * % 

WJien in nervovs temperaments, Coffea, Ignatia, Sulph., etc. 

Heartburn. — Waterbrash. — Nux vom., Cham., Pulsatilla, China, 
Carbo. veg., and Belladonna. 

Cardial^ia. — Gastralgia. — Belladonna, Bryonia, Calcarf*#, Carbo. 



HOMCKOPATHIC REMEDIES. 513 

veg., Chamomilla, China, Cocculus, Coffea, Ignatia, Nux vomica, 
Pulsatilla. 

Sea-Sickuess. — Cocculus, Colchicum, Sepia, and Staphysagria. 

Voinitiu^ of Hucus. — Ipecacuanha, Rheum, and Veratrum. 

Tomitin^ of Blood. — Aconite, Arnica, Arsenicum, China, Ipecac, 
Nux vomica, Pulsatilla, and Sulphur. 

Costiveness. — Alumina, Antim. crud., Bryonia, China, Calcarea 
carb., Cocculus, Lycopodium, Lachesis, Nux vomica, Opium, Pulsa- 
tilla, Plumbum, Sepia, Sulphur, and Veratrum. 

, Diarrhoea. — Arsenicum, Antimonium crud., Bryonia, Calcarea 
carb., Chamomilla, China, Colocynthis, Dulcamara, Ipecac, Mercu- 
rius, Nux vomica, Phosphoric acid, Pulsatilla, Rhus tox., Secale, Sul- 
phur, and Veratrum. 

Dysentery. — Aconite, Arnica, Arsenicum, Belladonna, Bryonia, 
Chamomilla^ China, Colocynth, Mercurius corro., Nux vom., Pulsa- 
tilla, and Sulphur. 

Cholera Morbus. — Arsenicum, Chamomilla, China, Cuprum, Ipecac, 
Nax vomica, Veratrum. 

Asiatic Cholera. — Arsenicum, Carbo. lig., Camphor, Cuprum, Ipecac, 
Phosphorus, Phosphoric acid. Sulphur, and Veratrum. 

Painter's Colic. — Aconite, Belladonna, Chamomilla, China, Coccu- 
lus, Colocynthis, Ignatia, Mercurius viv., Nux vomica, Pulsatilla, and 
Sulphur. 

Flatulency. — China, Nux vomica, Pulsatilla, Sulphur. 

Inflammation of the Stomach. — Aconite, Arnica, Arsenicum, Bel- 
ladonna, Bryonia, Chamomilla, China, Hyoscyamus, Ipecacuanha, 
JNIercurius viv., Nux vgmica, Pulsatilla, Sulphur, and Veratrum. 

Inflammation of the Bowels. — Aconite, Arsenicum, Arnica, Bella- 
donna, Bryonia, Chamomilla, China, Cantharis, Colocynth, Colchi- 
cum, Lachesis, Nux vomica. Nitric acid, Pulsatilla, Rhus tox., Silicea, 
Sulphur, Tartar emetic, and Veratrum. 

Chronic luflammation of the Bowels. — Nitric acid. Sulphur, Arse- 
nicum, Silicea, Phosphorus. 

Inflammation of the Peritoneum. — Aconite, Arnica, Belladonna, 
Bryonia, Cantharides, Chamomilla, Colocynthis, Lycopodium, Nux 
vomica, and Rhus. 

Worms. — Aconite, Belladonna, Carb. veg., phamomilla, China, 
Cina, Calcarea carb., Ipec, Lachesis, Mercurius viv., Nux vomica, 
Pulsatilla, Sulphur, Silicea. 

Itching of the Anus. — If caused by worms. Aconite, Nux vomica. 
Sulphur, and Silicea ; if caused by blind piles, or bleeding, or liquor, 
etc., Nux VQpica, China, Sulphur, or Ipecacuanha. 

65 



oi4 HOMCEOPATHIC REMEDIES. 

Piles. — Aconite, Antimanium crud., Arnica, Belladonna, Carbo. 
veg., Chamomilla, Colocynthis, China, Hamanielis, Ignatia, Mercu- 
rius viv., Nux vomica, Pulsatilla, and Sulphur. 

Protrusion of the Intestine. — Calcarea, Ignatia, Mercurius, Nux 
vomica, Lycopodium, Sepia and Sulphur. 

Acute Inflammation of the Liver. — Aconite, Bryonia, Belladonna, 
Chamomilla, China, Mercurius viv., Nux vomica and Lachesis. 

Chronic Inflammation of the Liver. — Aurum, Alumina, Calcarea 
carb., China, Lycopodium, Nux vomica, Silicea and Sulphur. 

Janndice. — Aconite, Belladonna, Chamomilla, China, Digitalis, 
Mercurius viv., Nux vomica, Pulsatilla and sulphur. 

Inflammation of the Spleen. — Aconite, Arnica, Arsenicum, Baryta 
carb., Bryonia, China, Calcarea carb., Carbo. veg., Ferrum, Lycopo- 
dium, Nux vomica, Plumbuni, Platina, Rhus tox., Stannum and Sul- 
phur. 

Inflammation of the Kidneys. — Aconite, Arnica, Belladonna, Can- 
nabis, Cantharides, Cocculus, Colchicum, Hepar sulph., Mercurius, 
Nux vomica, and Pulsatilla. 

Inflammation of the Bladder. — Aconite, Cantharides, Arsenicum, 
Digitalis, Hyoscyamus, Nux vomica, and Pulsatilla. 

Chronic Inflammation of the Bladder. — Dulcamara, Pulsatilla and 
Sulphur. 

Gravel. — Cantharides, Calcarea carb., Cannabis, Nux vomica. Nit. 
acid, Lycopodium, Phosphorus and Sarsaparilla. 

Retention of Urine. — Aconite, Belladonna, Arnica, Camphora, Ar- 
senicum, Sulphur, Pulsatilla, Cantharides, Dulcamara, Nux vomica. 
Opium, Staphysagria, Phosphorus. 

Stran<?ury. — Aconite, Belladonna, Hepar sulph., Mercurius viv., 
Nux vomica, Pulsatilla and Sulphur. 

Suppression of Urine. — Aconite, Camphor, Cantharides, Nux vom., 
Pulsatilla, Belladonna, Opium, Lycopodium and Sulphur. 

Incontinence of Urine. — China, Nux vomica. Opium, Calcarea 
carb.. Sulphur, and others. 

Wetting the Bed at IVight. — Carbo. animalis, Cina, Causticum, 
Belladonna and Sulphur. 

Diabetes. — Kali carbo.. Muriatic acid, Mercurius, Veratrum, and 
Staphysagria. 

Blood Passed with the Urine.— The same remedies as for reten- 
tion of urine or gravel. 

Clap.— Gleet. — Aconite, Cannabis, Mercurius viv.. Sulphur, Can- 
tharides. 



HOMCEOPATHIC REMEDIES. 515 i' 



luflaiiuiirttioii of the Testicles. — Aconite, Arnica, Aurum, China, 
Graphites, Lycopodinm, Mercurius viv., Nux vomica, Pulsatilla and 
Sulphur. 

Dropsy of the Scrotum. — Pulsatilla, Sulphur and Silicea. 

Syphilis. — Mercurius vivus and Mercurius corrosivus, Nitric acid, 
Arsenicum, and Sulphur. 

Boils. — Arnica, Aconite, Belladonna, Hepar sulph., Mercurius and 
Sulphur. 

Carbuncle. — Arsenicum, Hepar sulph., Lachesis, and Silicea. 

Chilblains. — For internal use, Arsenicum, Chamomilla, Nux vom., 
Pulsatilla, Phosphorus and Sulphur. For external use, Tinct. of 
Cantharides, Tinct. of Arnica, Rhus tox., and Tinct. of Causticum. 

Corns. — Antimonium crud.. Ammonium carb., Bryonia, Calcarea, 
Ignatia, Lycopodium, Phosphorus, Sepia, Silicea and Sulphur. For 
external treatment, Tinct. of Arnica. . 

Abscess. — For the acute abscess, Calcarea carb., Hepar sulph., La- 
chesis, Mercurius, Phosphorus, and Silicea ; for the chronic abscess, 
Mercurius viv., Hepar sulph., Silicea, Calcarea and Sulphur. 

Itch. — Sulphur, Calcarea, Heper sulph., Lycopodium, Sepia, Sulph. 
acidum, Stramonium and Rhus tox. 

Whitlow. — Mercurius, Hepar sulph., Rhus tox., Lachesis, Silicea, 
and Sulphur. 

Itching of the Shin — Prurigo. — Sulphur, Conium, Ignatia, Mer- 
curius, Pulsatilla, Rhus tox., Hepar sulph., and Nux vomica. 

Ring M'onii. — Sepia, Natrum muriaticum, Nux vomica, Calcarea 
carb., Rhus tox., and Sulphur. 

Ring Worm of the Scalp. — Arsenicum, Hepar sulph., Ducamara, 
Bryonia, Rhus tox., and Staphysagria. 

Ulcers, — Arsenicum, Carbo. veg., Lachesis, Lycopodium, Mercu- 
rius viv., Silicea, Sulphur, Sepia and Nitric acid. 

Varicose Llcers. — Arnica, Pulsatilla, Lachesis, Sulphur, Silicea, 
Arsenicum, Carbo. veg. 

Hives. — Chamomilla, Ipecacuanha, and Bryonia. 

Catarrh in the Head. — Aconite, Arsenicum, Belladonna, Bryonia, 
Chamomilla, Causticum, Euphrasia, Hepar sulph., Lycopodium, Mer- 
curius viv.. Nitric acid, Nux vomica, Phosphorus, Pulsatilla, Rhus tox., 
Sambucus, Silicea and Sulphur. 

Cold. — Influenza. — Aconite, Arsenicum, Bryonia, Belladonna, 
Chamomilla, Camphor, Conium, Causticum, Dulcamara, Hepar 
sulph., Merculrius viv.. Phosphorus, Pulsatilla, and Rhus tox. 

Cough. — Aconite, Antimonium crud., Arsenicum, Belladonna, 
Bryonia, Chamomilla, Causticum, Carbo. veg., Calcarea carb., Dul- 



516 HOMGEOPATHIC REMEDIES. 

camara, Drosera, Hepar sulph., Hyoscyamus, Ignatia, Lachesis, Lyco- 
podium, Mercurius viv., Nux vomica, Pulsatilla, Rhus tox., Sepia, 
Siiicea and Sulphur. 

Hoarseness. — Arsenicum, Belladonna, Causticum, Cuprum, Cap- 
sicum, Hepar sulph., lodium. Kali carb., Lachesis, Mercurius vivus, 
Pulsatilla, Rhus tox.. Sulphur, Siiicea, Stannum. 

LarjTi^itis. — Camphor, Aconite, Hepar sulph., Spongia, Lachesis, 
Antimonium crud., Arsenicum, Belladonna, Cantharis, lodium, Mer- 
curius cor., Phosphorus, Rhus tox. 

Croup, — Antimonium crud., Arsenicum, Belladonna, Bryonia, 
Cantharis, lodium. Kali carb.. Phosphorus, Tart, emetic, Sambucus. 

Spasmodic Croup. — Aconite, Belladonna, and Sambucus. 

Chronic Laryngitis. — Argentum, Arsenicum, Belladonna, Carbo. 
veg., Calcarea carb., Hepar sulph., Lachesis, Nitric acid, Phosphorus, 
Sanguinaria, Spongia, Siiicea, Sulphur. 

PliarjTigitis. — Aconite, Chamomilla, Belladonna, Mercurius viv., 
Nux vomica. Sulphur. 

Quinsy. — Aconite, Arsenicum, Aurum, Belladonna, Chamomilla, 
Hepar sulph., Lachesis, Mercurius viv., Nitric acid, Pulsatilla, Rhus 
tox., Siiicea, Sulphur. 

Chronic Pliarjngitis. — - Arsenicum, Antimonium crud., Bryonia, 
Calcarea carb., Causticum, Graphites, Hepar sulph., Kali carb.. Phos- 
phorus, Rhus tox., Siiicea, Sulphur. 

Hooping Cough. — In the forming, or feverish stage. Aconite, Bella- 
donna, Bryonia, Ipecacuanha, Nux vomica. Phosphorus, Pulsatilla, 
Tartar emetic ; in the second, or nervous stage, Carbo. veg.. Cuprum, 
Drosera, Opium and Veratrum. 

Bronchitis. — Aconite, Belladonna, Bryonia and Phosphorus; and, 
next to these, Lachesis, Mercurius vivus, Pulsatilla, Nux vomica, Rhus 
tox., and Spongia. 

Lung Fever. — Aconite, Belladonna, Bryonia, Phosphorus, Rhus 
tox., Tartar emetic, and Sulphur. 

Typhoid Pneumonia. — Arnica, Arsenicum, Opium, Phosphorus, 
Rhus tox., and Veratrum. 

Pleurisy. — Aconite, Arnica, Arsenicum, Bryonia, Belladonna, 
Phosphorus, Rhus tox., and Sulphur. 

Asthma. — Aconite, Arsenicum, Belladonna, Bryonia, Cuprum, 
Ipecacuanha, Lachesis, Moschus, Nux vomica, Pulsatilla, Sambucus, 
Tartar emetic, and Veratrum. 

Bleeding from the Lungs. — Aconite, Arnica, Arsenicum, Bella- 
donna, China, Ferrum, Ipecacuanha, Opium, Pulsatilla, Phosphorus, 
and Rhus tox. 

Consumption. — Aconite, Arsenicum, Belladonna, Calcarea carb.. 



HOMCEOPATHIC REMEDIES. 517 

China, Kali carb., Lycopodium, Phosphorus, Pulsatilla, Sepia, Stan- 
num, Sulphur. 

XeiiTjUgia of the Heart. — Aconite, Arnica, Arsenicum, Belladonna, 
Bryonia, Digitalis, Ipecacuanha, Lachesis, Phosphoric acid. Sulphur 
and Veratrum. 

Acute Pericarditis. — Aconite, Arnica, Arsenicum, Belladonna, 
Bryonia, Cannabis, Lachesis, Spigelia, and Sulphur. 

Clironic Pericarditis. — The same remedies as for acute pericarditis, 
Avith the addition of Aurum muriat, Calcarea carb.. Phosphorus, Ly- 
copodium, Silicea, Colchicum, and Ledum. 

Endocarditis. — Aconite, Arsenicum, Belladonna, Digitalis, Nux 
vomica, Pulsatilla, Spigelia, and Veratrum. 

Carditis. — Arsenicum, Bismuth, Nux vomica, Pulsatilla, Phospho- 
rus, and Graphites. 

Dilatation of tlie Cavities of the Heart. — Arsenicum, Aconite, Ar- 
nica, Belladonna, Digitalis, Lachesis, Pulsatilla, and Spigelia. 

Diseases of the Valves of the Heart. — Assafoetida, Arsenicum, Bel- 
ladonna, Croton, Digitalis, Graphites, Lachesis, Phosphorus, Pulsatilla, 
Rhus and Spigelia. 

Anenrisni of the Aorta. — Arsenicum, Arnica, Belladonna, Croton, 
Digitalis, Lachesis, Rhus tox., Zincum. 

Diseases of the Brain and Nerves. 

Rnsh of Blood to the Head. — Aconite, Arnica, Belladonna, CofFea, 
Chamomilla, Ignatia, Mercurius viv., Nux vomica. Opium, Pulsatilla. 

Brain Fever. — Aconite, Belladonna, Bryonia, Cuprum met., Hyos- 
cyamus. Opium, Stramonium and Zincum. 

Apoplexy. — Aconite, Belladonna, Ignatia, Lachesis, Nux vomica 
and Pulsatilla. 

Acute Inflammation of the Spinal Cord. — Aconite, Belladonna, 
Bryonia, Hyoscyamus, Stramonium, and Sulphur. 

Palsy. — Arnica, Bryonia and Sulphur. 

Lockjaw. — Arnica, Belladonna, Hyoscyamus, Lachesis, Stramo- 
nium, Opium, Rhus tox., Mercurius viv. 

Delirium Tremens. — Aconite, Belladonna, Calcarea, Nux vomica. 
Opium, Hyoscyamus, Lachesis, and Sulphur. 

Epilepsy. — Belladonna, Cuprum, Hyoscyamus, Ignatia, Lachesis, 
Nux vomica. Opium and Stramonium. 

Neuralgia. — Arsenicum, Belladonna, China, Colocynth, Lycopo- 
dium, Platina, Spigelia. 

St. Vitus's Dance. — Belladonna, Pulsatilla, Stramonium, Hyoscya- 
mus, Nux vomica, and Sulphur, 



518 HOMOEOPATHIC REMEDIES. 

Stammering. — Belladonna, Hyoscyamus, Sulphur, Causticum, and 
Calcarea. 

Headache. — Belladonna, Bryonia, Rhus tox., Nux vomica, Pulsa- 
tilla, Sepia, Chamomilla, Sulphur, Calcarea, Arsenicum, Aurum, 
China, Lachesis, Mercurius, and Veratrum. 

In the treatment of headaches, much advantage is to be derived 
from a knowledge of the causes which produce them ; we will there- 
fore state concisely : 

1. Headache from determination of blood to the head, Aconite, 
Belladonna, Pulsatilla, etc. 

2. Headache from cold in the head or catarrh, Aconite, Arsenicum, 
China. 

3. Headache from rheumatism, Bryonia, Chamomilla, Nux vomica, 
Pulsatilla, etc 

Headache from disordered bowels, Ignatia, Ipecacuanha, Nux vom., 
Veratrum. 

5. Headache from constipation, Bryonia, Lycopodium, Nux vomica, 
Opium, etc. 

6. Headache arising from affection of the nerves (Nervous Head- 
ache)^ Aconite, Bryonia, Coffea, Nux vomica, Pulsatilla, Sepia, Sul- 
phur, etc. 

7. Headache caused by suppression of eruptions, Belladona, Cal- 
carea, and Sulphur. 

Giddiness* — Aconite, Arnica, Chamomilla, Nux vomica, Pulsa- 
tilla. 

Loss of Memory. — China, Arnica, Nux vomica, Ignatia. 

Diseases of Various Organs and Regions. 

Inflammation of the Psoas Mnscle. — Aconite, Belladonna, Colo- 
cynth, Hepar sulph., Silicea, and Staphysagria. 

Coxalgia. — Aconite, Arsenicum, Belladonna, Chamomilla, Colo- 
cynth, Hepar sulphur, Pulsatilla and Rhus tox. 

Affections of the Knee. — Silicea, Aurum, Calcarea, Lycopodium, 
Nitric acid. Phosphoric acid. Sulphur, Bryonia, China, Nux vomica, 
Rhus tox., and Sulphur. 

Inflammation of the Eye-lids. — Aconite, Chamomilla, China, Eu- 
phrasia, Hepar sulph., Nux vomica, Mercurius and Rhus tox. 

St}'e. — Pulsatilla, Staphysagria, and Sepia. 

Iritis. — Aconite, Belladonna, Chamomilla, Euphrasia, Ignatia, Nux 
vomica, Pulsatilla, Rhus tox., and Veratrum. 

Scrofulous Ophthabnia.— Arsenicum, Belladonna, Calcarea, China, 
Dulcamara, Hepar sulph., Mercurius and Sulphur. 

Syphilitic Sore Eyes.— Mercurius; if the patient have been previ- 
ously treated with mercury. Nitric acid, Aurum, Sulphur. 



HOMCEOPATHIC REMEDIES. 519 

Goiiorrlioeal Inflammation of the Eyes. — Pulsatilla, Arnica and 
Sulphur. 

Cataract, — Conium, Phosphorus, Cannabis, Sulphur. 

Specs on the Cornea. — Belladonna, Euphrasia, Sulphur and Cal- 
carea. 

Squinting. — Hyoscyamus, Belladonna. 

Watery Eyes. — Petroleum, Stramonium, Calcarea, Pulsatilla, Sul- 
phur, Lachesis. 

Bloodshot Eyes. — The external use of Arnica, or, internally. Bella- 
donna, Chamomilla, Nux vomica. 

Short Si^htedness. — Pulsatilla, Sulphur, Carbo. veg.. Phosphoric 
acid. Petroleum. 

Inflammation of the Ear. — Belladonna, Pulsatilla. 

Ear-Ache. — Arnica, Calcarea, China, Mercurius, Nux vomica, 
Chamomilla, Dulcamara, Hepar sulph., Phosphoric acid, Pulsatilla, 
Platinum, and Sulphur. 

Ronnincc of the Ears. — Belladonna, Calcarea, Mercurius, Pulsa- 
tilla and Sulphur. 

Deafness. — Calcarea, Mercurius, Nitric acid, Phosphoric acid. 
Phosphorus, Pulsatilla and Sulphur. 

Deafness from Congestion. — Belladonna, Hyoscyamus, Phosphorus, 
Sulphur. 

Xenons Deafness. — Causticum and Phosphoric acid. 

Rheumatic Deafness. — Arsenicum, Calcarea, Mercurius, Nitric acid, 
Pulsatilla. 

Deafiiess from Suppressed Eruptions. — Causticum, Graphites, Sul- 
phur. 

Deafness from Measles, Carbo. veg., Pulsatilla ; from scarlet fever, 
Belladonna, Hepar Sulph. ; from small-pox, Mercurius viv., and Sul- 
phur ; from abuse of mercury, Aurum and Nitric acid ; from enlarge- 
merit of tonsils, Aurum, Mercurius, Nitric acid; from suddenly checked 
discharges from nose or ears, Hepar sulph., Lachesis, Pulsatilla ; as a 
sequel of fevers and other disorders, Phosphorus, Phosphoric acid and 
Veratrum. 

Bleeding at the Nose. — Aconite, Arnica, Belladonna, Bryonia, Cina, 
China, Nux vomica, Pulsatilla, Rhus tox., and Sulphur. 

Ozcena. — Pulsatilla, Sulphur, Calcarea, Lycopodium and Natrum 
muriaticum. 

Polypus of the Nose. — Calcarea, Sanguinaria, Sepia and Staphy- 
sagria. 

Baldness. — When the hair falls from debility, Chiha and Eerrum. 
When it falls in consequence of perspiration, Mercurius. 



520 HOMOEOFATHIC REMEDIES. 

If from the use of quinine, Belladonna. 
If from the abuse of mercury, Carbo. vegetabilis. 
If from grief and trouble. Phosphoric acid and Staphysagria. 
If after inflammatory diseases and nervous fevers, Calcarea, Hepar 
sulph., and Silicea. 

Dandruff. — Lycopodium. . 

Oflfensive Breath. — Chamomilla, Nux vomica, Pulsatilla, and Sul- 
phur. 

Cramps in the Legs. — Veratrum, Colocynth, Sulphur, Rhus tox., 
Sepia, Nitric acid, Lycopodium, Nux vomica, and Calcarea. 

Goitre. — Iodine and Spongia, in recent cases ; and Calcarea, Carbo. 
veg., and Sepia, in those of long standing. 

Sweating Feet. — Silicea and Rhus tox. 

Sleeplessness. — Nux vomica, Pulsatilla, Coflfea, Phosphoric acid. 
Sepia, Sulphur, Lycopodium, Lachesis, Stannum, Secaie, and Nitric 
acid. 

Nightmare. — Aconite, Nux vomica, Pulsatilla, Opium, Sulphur 
and Silicea. 

Rupture. — For old cases, trusses; for recent cases. Aconite, Nux 
vomica, Veratrum, Opium, Arsenicum and Lachesis. 

Fainting. — Aconite, Coffea, Hepar sulph., Lachesis, Nux vomica, 
and Veratrum. 

Pain in the Loins. — Calcarea, Nux vomica, Rhus tox., and Sul- 
phur. 

Cell Dropsy.— Anasarca. — Arsenicum, Bryonia, China, Helleborus, 
Mercurius and Phosphorus, 

Dropsy of the Belly. — Helleborus, Arsenicum and China. 

Dropsy of the Chest. — Apis melifica, Arsenicum, Colchicum, Dul- 
camara, Spigelia. 

Dropsy of the Brain.— Aconite, Belladonna, Bryonia, Hyoscya^ 
mus, Helleborus, Mercurius vivus, Opium, Stramonium, Sulphur, 
Zincum metallicum. 



Surgical Diseases. 

Concnssion of the Brain. — Arnica, 

Concussion of the Chest. — Aconite, Arnica, Pulsatilla, Mercurius, 
Nux vomica, China, Bryonia, Opium, Chamomilla. 

Sprains. — Arnica, both internally, and externally as a lotion, Rhus 
tox., Bryonia, Pulsatilla, and Ruta. 

Hemorrhage from Wounds. — Arnica and Calendula, both exter- 
nally and internally, China. 



HOMEOPATHIC REMEDIES. 521 

Lacerated M'ouuds. — Chamomilla, Hepar sulph., Silicea and Sul- 
phur. 

Contused Wounds and Bruises. — Ten drops of tincture of arnica 
in half a tumbler of water, to be applied as a lotion ; internally, 
Rhus tox., Ruta, Arnica, China, Lachesis, Arsenicum, Aconite, Cal- 
endula, Hepar, Silicea. 

Punctured Wounds. — Aconite, Belladonna, Mercurius, Hepar, 
Chamomilla, Rhus tox., Cicuta, Arnica. 

Gunshot Wounds. — Hepar sulph., Silicea, Sulphur and Aconite. 

Bite of a Serpent. — Arsenicum, Belladonna, Phosphoric acid, Mer- 
curius, Senega. 

Dislocations. — Arnica, Aconite. 

Fractures. — Arnica, Ruta. 

Bums and Scalds. — Arnica, Carbo. veg., Coffea, Hepar sulph., 
China, Aconite, Opium, Arsenicum, Nitric acid. 

Stingos of Insects. — Internally, Aconite, Arnica, Belladonna, Mer- 
curius viv.; externally. Lemon juice and Arnica lotion. 

Hydrophobia. — Dry or radiating heat, Belladonna, Cantharides, 
Hyoscyamus, Lachesis, and Stramonium. 

Mental Emotions. — For affections brought on by fright, terror, or 
horror. Aconite and Ignatia ; if there be fever and heat of head from 
these causes. Aconite ; for extreme nervous excitement. Belladonna ; 
for disease caused by suppressed emotions, Ignatia ; for sufferings 
arising from vexation, Chamomilla ; for those arising from sudden 
fits of passion, Nux vomica ; for those arising from anger for just 
cause, Staphysagria ; for great weakness and prostration from a fit 
of passion, Arsenicum ; for coldness and shivering, loss of appetite, 
nausea and vomiting, brought on by a fit of passion, Bryonia ; for 
the ill effects of excessive joy, Coffea ; for the injurious effects of jeal- 
ousy, or disappointed love, Hyoscyamus ; for sufferings from unre- 
quited affections, Ignatio and phosphoric acid ; for the effects of mor- 
tification, Pulsatilla, Belladonna and Platina. 

Diseases of Women. 

Obstructed Menstruation. — Pulsatilla and Bryonia. 

Chlorosis. — Bryonia, Calcarea carb., Ferrum, Natrum muriaticum. 
Plumbum, Pulsatilla, Sepia and Sulphur. 

Tardy Menstruation. — Arsenicum, Bryonia, Belladonna, Cocculus, 
Cuprum, Lachesis, Lycopodium, Phosphorus, Pulsatilla, Sulph. acid, 
Sepia and Veratrum. 

Suppression of the Menses. — Aconite, Pulsatilla, Belladonna, Bry- 
onia, China, Graphites, Kali carbonicum. Sepia, Sulphur, and Vera- 
trum. 

66 



522 HOMCEOPATHIC REMEDIES. 

Too Frequent Menstruation. — Belladonna, Calcarea carb.. Ipecacu- 
anha, Natrum mur., Nux vomica, Platina, and Sulphur. 

Menstruation too Profuse. — Calcarea carb., China, Chamomilla, 
Crocus, Ignatia, Ipecacuanha, Nux vomica, Platina, Sabina and Sul- 
phur. 

Painful Menstruation. — Belladonna, Chamomilla, Pulsatilla, Nux 
vomica, Lachesis, Coft'ea, Cocculus, Causticum, and Veratrum. 

Change of Life. — Pulsatilla, Lachesis, Aconite, Apis melifica, Ar- 
senicum, Bryonia, Cocculus, Ipecacuanha, Ignatia, Sepia and Sul- 
phur. 

Hysterics. — CofFea, Cocculus, Cuprum, Ignatia, Lachesis, Platina, 
Pulsatilla, Assafoetida, Aurum, Belladonna, Conium, Moschus, Nux 
moschata, Secale, Veratrum. 

Whites. — Calcarea carb., Causticum, Cocculus, Natrum mur., Pul- 
satilla, Sepia and Sulphur. 

Falling of the Womb. — Aurum, Arnica, Belladonna, Calcarea carb., 
Nux vomica, Sepia, Creosote, Mercurius, Platina, Conium, and Stan- 
num. 

Dropsy of the Womb. — Aconite, Apis mel., Arsenicum, Bryonia, 
China, Calcarea, Ignatia, Nux vomica, Pulsatilla, Secale, Sepia and 
Sulphur. 

Inflammation of the Ovaries. — Apis melifica, Antimonium crud., 
Arsenicum, Belladonna, Cantharis, Cannabis, Cocculus, Conium, 
Graphites, Hepar sulph., lodium. Kali carbonica, Lachesis, Nux vom., 
Phosphorus, Pulsatilla, Sepia and Sulphur. 

Dropsy of the Ovaries. — The same as the remedies for dropsy of 
the womb. 

Inflammation of the Vagina, etc. — Arnica, Rhus tox., Mercurius, 
Belladonna. 

States of Mind, etc., during* Pregnancy. — For despondency, with 
hot skin and quick pulse. Aconite ; for inquietude and fear of the 
future, Bryonia ; for excessive dejection and great lassitude, Calcarea 
carbonica ; for melancholy, with weeping, Natrum muriaticum ; for 
morning sickness, constipation, and fretfulness, Nux vomica ; for low 
spirits during the nursing period, when the energies of the mother are 
too much taxed, China, Aurum, Lachesis, or Pulsatilla. 

Menstruation continued during Pregnancy. — Calcarea carb., China, 
Chamomilla, Ignatia, Ipecac, Nux vomica, Platina, Sabina, Sulphur, 
Cocculus, Crocus, Phosphorus. 

Dizziness and Headache during Pregnancy. — Aconite, Belladonna, 
Nux vomica. Opium, Platina, Pulsatilla and Sulphur. 

Itching of the Genitals. — Mercurius, Rhus tox., and Sulphur. 

Tooth- Ache. — Chamomilla, Mercurius, Nux vomica and Pulsatilla. 



HOMCEOPATHIC REMEDIES. 523 

Cninips during Pre«:iiaiioy. — For cramps of the legs, Calcarea 
carbonica, Chamoinilla, Colocynth, Graphites, Hyoscyamus, Nux 
vomica, and Sulphur; for those of the back, Ignatia, Opium and 
Rhus toxicodendron ; and for those of the abdomen. Belladonna, 
Colocynthis, Hyoscyamus, Nux vomica and Pulsatilla. 

Incontinence of Urine in Pregnancy. — Pulsatilla, Belladonna, China, 
Silicea or Stramonium. 

Piles durino^ Pregnancy. — Aconite, Arnica, Belladonna, Hamame- 
lis virg., Sulphur and China. 

Varicose Veins in Pregnancy. — Arnica, Hamamelis virg., Nux vom., 
Pulsatilla, Apis mel., Arsenicum, Lachesis, and Lycopodium. 

Flooding. — Arnica, Bryonia, Belladonna, Chamomilla, China, Cro- 
cus, Ferrum, Hyoscyamus, Hamamelis virg., Ipecacuanha and Pla- 
thia. 

Miscarriage. — Arnica, Belladonna, Bryonia, Chamomilla, China, 
Crocus, Ferrum metallicum, Hyoscyamus, Ipecacuanha, Nux vomica, 
Platina, Sabina and Secale. 

Care of Breast, etc., before Confinement. — If there be tenderness or 
excoriation, apply a weak dilution of Tincture of Arnica ; for shoot- 
ing pains in the breasts, take internally, Aconite, Belladonna, Bryonia, 
Chamomilla, and Rhus tox. ; for swelling, burning, itching, cracks and 
eruptions, Bryonia, Graphites, Lycopodium, Mercurius, Hepar sulph., 
Rhus tox., and Sulphur. 

False Pains. — Aconite, Bryonia, Belladonna, Dulcamara, Nux 
vomica, and Pulsatilla. 

Childbirth.— Protracted Labors. — Aconite, Belladonna, Chamomilla, 
Coffea, Nux vomica. Opium, Pulsatilla and Secale. 

Childbirth Cramps and Convulsions, — Belladonna, Chamomilla, 
Cocculus, Hyoscyamus, Ignatia, Ipicacuanha, and Stramonium. 

Flooding after Delivery. — Belladonna, Chamomilla, China, Cin- 
namon tincture. Crocus, Hamamelis virg., Platina and Sabina. 

The Lochia. — If it continue too long, or is too profuse. Aconite, 
Belladonna, Bryonia, Crocus, Carbo. animalis, Calcarea carb.. Dulca- 
mara, Opium, Platina and Pulsatilla. 

Milk Fever. — Aconite, Arnica, Bryonia, Belladoima, Chamomilla, 
Pulsatilla, Rhus toxicodendron. 

Suppression of Milk. — Pulsatilla, Aconite, Coffea. 

Sore Nipples. — Calcarea carb., Graphites, Lycopodium, Mercurius, 
Nux vomica. Sepia, Silicea and Sulphur. 

Broken Breasts. — Bryonia, Belladonna, Hepar sulph., Mercurius, 
Phosphorus and Sulphur. 



524 HOMOSOPATHIC REMEDIES. 



Diseases of Infants and Children. 

The Meconinm. — Should this be delayed for an unusually long 
time, Nux vomica, Sulphur, Bryonia, Lycopodium, Opium, or Silicea, 
may be useful. 

Mother's Marks. — Calcarea carb., Silicea, and Sulphur. 

Blue Disease. — Sulphur, Calcarea carb.. Digitalis. 

Sleeplessness. — Stramonium, Hyoscyamus, Opium. 

Regurgitation of Milk. — Ipecacuanha, Pulsatilla, Antimoniam 
crud., Chamomilla, Bryonia, or Nux vomica. 

Thrush. — Wash the mouth with a weak solution of borax ; if this 
do not succeed, give Mercurius, Sulphur, Sulphuric acid, Arsenicum, 
or Nitric acid. 

Exeoriations. — Internally, give Chamomilla, Pulsatilla, Ignatia, 
Mercurius, Sulphur, Carbo. veg., Lycopodium, Sepia, or Silicea, and 
apply a weak solution of Arnica externally. 

The Gum. — Aconite, Rhus toxicodendron, and Sulphur. 

Prickly Heat. — Aconite, Chamomilla, Rhus tox., Arsenicum and 
Sulphur. 

Scurf on the Head. — Sulphur, and Rhus tox. 

Soreness behind the Ears. — Graphites, Arsenicum, Calcarea carb., 
and Baryta carb. 

Milk Crust. — Aconite, Arsenicum, Hepar sulph., Rhus tox., and 
Sulphur, are the principal remedies. Also Belladonna, Euphrasia, 
Graphites, Lycopodium, Staphysagria, Sambucus, and Viola tricolor. 

Erysipelas. — Aconite, Arsenicum, Belladonna, Hepar sulph., La- 
chesis, Nux vomica, Rhus tox., Silicea and Sulphur. 

Runninn: from the Ears. — Belladonna, Chamomilla, Calcarea car- 
bonica, Mercurius, Pulsatilla, Rhus toxicodendron and Sulphur. 

Wetting the Bed. — Pulsatilla, Silicea, Rhus tox.. Sulphur, Cina, 
Causticum, Carbo. veg., lodium, Calcarea carb., and Natrum mur. 

Constipation. — Bryonia, Nux vomica. Opium, Sulphur, Lycopo- 
dium, Alumina, or Natrum mur. 

Diarrhoea. — Aconite, Belladonna, Chamomilla, Ipecacuanha, Mer- 
curius and Rheum. 

Cholera Infantum. — Antimonium crud., Arsenicum, Bryonia, Carbo. 
veg.. Dulcamara, Ipecacuanha, Mercurius, Nux vomica, Veratrum and 
Sulphur. 

Colic. — Chamomilla, China, Ipecacuanha, Nux vomica, and Pul- 
satilla. 



HOMCEOPATHIC KEMEDIES. 525 

Comnlsions. — Belladonna, Chamomilla, Coffea, Cina, Hyoscya- 
mus, Ignatia, Ipecacuanha, Mercurius, Opium, Stramonium, and 
Sulphur. 

Hiccough. — Nux vomica, Moschus, Ipecacuanha, and Sambucus. 

Marasmus. — Sulphur, followed by Calcarea carb., or Arsenicum. 

Dentition. — . When medicines are required, the following are to be 
used : Aconite, Belladonna, Chamomilla, Calcarea, Carbonica, CofFea, 
Cuprum, Mercurius, Nux vomica. Sulphur and Zincum. 



PROCESSES OF THE HYDROPATHIC TREAT1\IENT. 



For the description of the hydropathic appliances contained in the 
following pages, I am indebted, in substance, to the " Hydropathic 
Family Physician," by Joel Shew, M. D., author of several popular 
works upon the principles and practice of hydropathy. I have not 
uniformly adopted his exact language, which is not always the best 
he might have chosen to express his thoughts. 

Priessnitz is admitted to have been the originator of the hydro- 
pathic modes of treating diseases. He was an unlearned man, though 
he had original powers of mind ; and, imperfect as the treatment is, 
he benefited his race by conferring it upon the world. 

At first, and for some time, baths were made too cold, and were 
continued too long; the result was, much injury to the patient in 
many cases. Time and experience have brought a better adaptation 
of the temperature and continuance of the water appliances to the 
symptoms, constitution, and temperament of each patient. Formerly, 
weak, exhausted, and nervous persons, not less than the full-blooded 
and strong, were put into the wet-sheet pack, and reduced near to 
death's door ; and there is reason to believe that in some cases where 
the practice is in ignorant hands, this barbarity is not wholly discon- 
tinued. The practice, however, is now mainly in better hands ; and 
although I by no means admit its sufficiency as a system of remedial 
agencies, I am persuaded it is doing some good. Used in connection 
with the ancient system of regular medicine, which is the joint pro- 
duct of time, science, and experience, the water treatment, moulded 
and modified to the circumstances and strength of the patient, is an 
auxiliary of no mean power. As such, I accept it. As such, it is re- 
ceived by hundreds and thousands of regular practitioners throughout 
the world. Further than this, it never can or will be generally re- 
ceived. By pushing it beyond this, its rightful and honored sphere, 
its friends only limit its progress, and injure its influence. 

The following is the substance of Dr. Shew's description of hydro- 
pathic appliance. 

The Wet-Sheet Pack. 

In this process a coarse linen or cotton sheet is used, long enough 
to reach from the patient's head to the soles of his feet, and about 
two yards in width. The bed is stripped of all its covering, one or 




PROCESSES OF THE HYDROPATHIC TREATMENT. 527 

two pillows only being left for the head. One or two comforters are 
then spread upon it, and over these the same number of woollen 
blankets, which are less injured by wet than cotton comfortables. 
The sheet having been pretty well wrung out of cold water, — always 
pure and soft, if such can be had, — is then spread out smoothly upon 
the blanket. The patient, being undressed, lays himself upon the 
sheet, and, his arms being held up, an assistant laps one side of it 
over the body and lower limbs ; when, the arms bein^ dropped at the 
side, the other part of the sheet is, in like manner, lapped over. The 
blankets are then, one by one, brought over -^^^ j^g 

the person in the same way, and tucked 
under from head to foot. Comfortables 
may be added, if necessary. (Fig. 178.) 

It is always best to place a wet towel, 
covered with a dry one, on the patient's 
head while he is packed. If too much 
chill is not produced, the dry one may be 
left off. - 

This is the ordinary way of taking a pack 
in chronic disease. 

The wet sheet is one of the most soothing and agreeable of all the 
water appliances. Hence it is that it is so often misused. It is so 
delightful, and tends so much to produce slumber, that the patient 
never feels ready to get out of it. But this slumber, — so profound and 
sweet as it often is, — he should remember, mai/ h4 only an apoplectic 
stupor, which leaves him with a swimming head, attended with faint- 
ness, perhaps, and ending in a severe headache ; giving him, in short, 
a congestion of the brain. All this happens in consequence of robbing 
the skin too long of the air it should breathe. 

There has been a notion at some of the establishments that the 
wet sheet is to be used for sweating ; and to this end, the patient has 
been literally stewed hour after hour, in some cases, even four, live, 
and six hours in succession, with the view of sweating him. All 
such practice is hurtful. If the patient gets better under it, it is in 
consequence of the good effects of water used in other ways, coupled 
with the ever-important adjuncts, air, exercise, and diet. In later 
times, Priessnitz never sweat patients at all, much less in wet sheets. 
If a man must sweat, leave off the wet sheet assuredly, as that only 
hinders the operation. Use the blanket pack, or the vapor bath. 

How Lon^ shall the Pack Continue? — Here, too, there has been, 
and still is, much error in hydropathic practice. " Stay in the pack 
till you get warm," has been the old doctrine. But some get warm 
at first, and afterward get cold ; — so at least they feel. What is to 
be done ? 

One of Priessnitz's improvements was, to give short packs. " Re- 
main enveloped for fifteen or twenty minutes only," he said. " If you 
are not able to bear the pack in that way, take the rubbing wet sheet 
and the lighter processes until you are." In some cases he gave two 
or three of these short packs in succession, the patient rising between 



528 PROCESSES or tpie hydropathic treatment. 

each to take an airing, a rubbing wet sheet, or other bath, and then 
returning to the pack. 

Thus far the wet sheet has been spoken of as used in chronic dis- 
eases. In acute attacks it is managed differently, according to the^ 
case. If the object be to abstract caloric from the body, we cover the 
sheet but little, — with a single dry sheet, or a blanket or two, or, per- 
haps, with none of these. 

We know that if we keep a towel about a keg of water in a hot 
day, the water will be made cooler by evaporation. In the same way, 
when a patient is hot and feverish, we keep one, or, still better, two 
wet sheets around him, without other covering, and thus bring down 
the heat and circulation to any desirable degree. We sprinkle water 
upon the sheets, or rewet them as often as is necessary, — in some 
extreme cases of fever continuing them a whole week or more. Ex- 
perience teaches that the continuous application of the wet linen is, 
in such cases, a most serviceable application, and one that tends most 
powerfully to induce in the dermoid structure its natural and health- 
ful state. 

The Wet Sheet Acts by Absorption. — It draws morbific matter out 
of the hodfj^ as any one may see who applies the sheet for a short 
time, and then washes it. Observe, too, what an odor comes from 
the sheet when a diseased patient has been packed. At the same 
time, it absorbs the pure water into its finest tissues on a large scale, 
thus supplying that fluid which of all substances the system, under 
such circumstances, most needs. This moist warmth of the sheet 
also acts as a most soothing poultice. 

The Wet Dress. 

A MODIFICATION of the wet sheet, and in some respects an improve- 
ment, is the "wet dress,"so called. 

A coarse linen or cotton dress is made with large arms, so that one 
may take the application without help. The dress being wet and ap- 
plied, the patient lays himself upon blankets, in which he wraps himself 
just sufficiently to become comfortable. Or, he may have dry flannel 
dresses to put on over the wet one, and then lie in a common bed. 
In this application, the air is not excluded from the surface to any- 
thing like the same extent as in the common tight pack. Hence, a 
patient may remain in it a half, or the whole of the night, if he 
chooses, — being careful to become neither too warm nor too cold. 
Rewetting once or twice in the night will be of service. Often in a 
single night a bad cold may be thrown off in this simple way. 

The Half Pack. 

Many patients have so little reactive energy, that while they can 
bear a half pack, so called, the entire sheet would abstract so much 
caloric from the body as to injure them. In such cases, the sheet is 
to be applied so as to extend only from the arm-pits, or at most, from ■ 



TROCESSES OF THE HYDROPATHIC TREATMENT. 529 

the neck to the hips, leaving the lower extremities, as it were, in the 
dry pack. Sometimes the sheet is allowed to extend to the ankles, 
not including the feet. Packing the trunk of the body in wet towels, 
acts upon the same principle as the partial or half pack, and is, in 
many cases a valuable preliminary measure. It is well to take these 
preparatory steps when a patient who has suffered long from chronic 
disease, is beginning with the envelopment. 

The Folded Wet Sheet. 

In domestic practice, a modification of the wet sheet may be had 
by folding four-double a common coarse sheet, for enclosing the 
trunk from the armpits down. Two thicknesses of this are wet in 
cold water, to come next the body. 

This is a valuable application in a host of ailments, as pleurisy, 
inflammation of the lungs, inflammation of the bowels, colic, cholera, 
cholera morbus, rheumatism, painful menstruation, after pains, etc. 
This remedy, which can be applied in five minutes, will often soothe 
a patient quietly to sleep, whose lot, without it, would be a night of 
agony. One advantage of this application is, that if a patient is too 
weak to rise, the sheet may be opened in front, so that fresh water 
may, when needed, be sprinkled upon it, and wet towels may be 
added under it, upon the abdomen, if necessary. 

In all the methods of applying the wet sheet, there can be no pos- 
sible objection to using warm bricks, bottles, etc., for the feet when 
cold. 

Bath after the Pack. — It is the practice generally to take some 
form of the bath after the pack. If the patient is too feeble to rise, 
an ablution is performed while he is in bed. In other cases, a wet- 
sheet rubbing, shallow, plunge, towel, or other bath is resorted to, but 
not strictly of necessity. It is better, however, as a rule, to make the 
process a compound one, that is, to take some form of bath after the 
pack. This should also be followed by exercise in the open air, if it 
can possibly be taken. A pack, followed by a faithful turn at work, 
or by exercise in the open air, is always worth much more than when 
followed by rest within doors. 
• 

The Rubbing Wet Sheet. 

The rubbing wet sheet, too little appreciated, and too seldom used, 
is one of the most valuable of all the hydropathic resources. There 
is probably no other single application of water, in all the multiform 
modes of hydropathic medication, that can be made, on the whole, as 
useful as this. It is a tonic, a stimulant, a sedative, an antispasmodic, 
a derivative, or a febrifuge, according to the circumstances under 
which it is applied. 

We take a coarse linen sheet, — although cotton answers a very 
good purpose, — large enough to throw around the body like an In- 
dian's blanket. It is wrung more or less, according to the demands 

67 



530 



PROCESSES OF THE HYDROPATHIC TREATMENT. 



/ 




mmm 



of the case. Thereupon, it is thrown quickly around the patient's 

body, who, if strong enough, is in the standing posture ; and then, 

both patient and assistant set vigorously to ^^^ -^^^ 

work, rubbing over the sheet, not with it, 

as some do, three, four, or more minutes, 

until the surface becomes thoroughly warm 

(Fig. 179). 

If there is fever, less friction is required. 
After the wet sheet, comes a dry one, to 
be used in the same manner. Those who 
have sufficient reactive energy, — and most 
have, — may dry the body simply by fan- 
ning it with the dry sheet, the windows at 
the same time being open. This sort of 
air-bath exerts a highly pleasurable effect 
upon the skin. Instead of giving one a 
cold, it helps greatly to ward it off. This method of drying the body 
was one of Priessnitz's later improvements. 

The rubbing wet sheet, it should be remembered, is not a single 
application, capable of producing only one effect. It is used in three 
different gradations, and to produce very different results. It is well 
wrung, or only moderately wrung, or left quite wet and dripping. If 
a person is fatigued, or has a low degree of reactive energy, the first 
form is the one to adopt ; if there is not much fatigue, and good re- 
active energy, the second ; and if the patient is feverish, and the 
object is to abstract heat simply, we use the sheet quite wet and drip- 
ping; and we repeat it as many times in succession as the case may 
need. One great advantage is, that we give it before or after a wet 
pack, when no bath is at hand ; we also give it in connection with 
any other bath we m.ay choose. 

See how admirable a remedy the rubbing wet sheet is, when prop- 
erly understood ! A patient, — a child, perhaps, — is so feeble in the 
reactive power, that almost any form of bath we can give it sends the 
blood from the surface, making the lips and nails pale or blue, and 
the extremities cold, showing congestion of the internal organs. 
When a bath produces such effects, it is very apt, to say the least, to 
do more harm than good. But we can apply the rubbing wet sheet 
in such a way as to cause none of these ill effects ; besides, it may 
be repeated many times in the day, so as to give the patient the ad- 
vantage of a strong treatment ; for a lig-ht treatment, which can be 
easily borne, is made a strong- one by the frequency of its repetition. 

A wet sheet, well wrung, holds perhaps a pint of water ; or, at 
most, a quart. Now, it must appear plain, that a pint or quart of 
cold water, spread over so large a surface as the whole skin, must be- 
come very easily warmed by the body's heat. Besides, if there is 
great delicacy of constitution, we may wring the sheet out of water 
at seventy, eighty, or even ninety degrees, gradually lowering it as 
the patient can bear it. 

The domestic availability of this application is also to be spoken of. 
In every dwelling, however humble, there is the coarse sheet, and the 



PKOCESSES OF THE IIYDKOrATHIC TREATMENT. 531 

bucket of water. How useful, therefore, as a resort, in home prac- 
tice I 

The rubbing wet sheet appears a trifling application, — one which 
is not capable of producing any great result. But when we remem- 
ber the myriads of nerves of animal life, spread over the skin, and 
derived from the brain and spinal cord, it need not surprize us that 
its application should so invigorate the body, take off bodily and 
mental depression, remove languor and fatigue, expel flatus from the 
bowels, remove thirst, give appetite, and cause a feeling of calmness 
and relief which can be appreciated only by those who experience it. 
A minister, for example, preaches three times on a Sunday, and gets 
his brain so excited that he cannot sleep. A cold bath would be too 
powerful, and opiates would only act as stimulants, making the mat- 
ter worse. Two or three successful applications of the rubbing wet 
sheet, with powerful friction, bring the blood so much to the surface, 
that his brain becomes relieved, and he very soon falls into a sound 
and refreshing sleep. So, too, when a man has been long wet and 
drenched on a rainy day, and comes home, with the surface and ex- 
tremities cold, and the blood pressing hard upon the brain and other 
internal organs, — the well-wrung rubbing sheet is applied, with plen- 
tiful friction, and at once the oppressed organs are set free. 

In using the rubbing wet sheet, as in all other forms of general 
bath, it is well to wash the hands and face in cold water, both before 
and after it. There is no need of throwing it over the head, as some 
have thought it necessary to do. A patient needs to breathe freely 
when he takes a bath. 

This application is not always the most pleasant one. It does, in 
fact, require a good degree of moral courage to enable one to endure 
the first shock. The sensations produced by it are worse, if possible, 
than those from a plunge into cold water ; 1 mean the first touch of 
the sheet to the body. Nervous ladies sometimes tell us they cannot 
take the rubbing wet sheet, when, at the same time, they take the 
cold plunge, which is far more powerful, and perhaps too powerful for 
their case. This unpleasant feeling does no harm, for it vanishes in a 
moment or two after the sheet touches the body. 

The Douche Bath. 

This is the most powerful, but not the most useful, of all the hydro- 
pathic appliances. A common douche consists of a stream of water 
from one to two inches in diameter, with a fall of ten, fifteen, or 
twenty feet. But douches may be arranged of any desirable size and 
height. (Fig. 180.) 

This remedy is useful in paralysis, stiff joints, gout, rheumatism, 
tumors, and old swellings of various kinds. Those who have weak 
lungs, stomach, or other abdominal organs, should not resort to the 
douche without the best of medical advice. 



532 



PROCESSES OF THE HYDROPATHIC TREATMENT. 



The Shower Bath. 

This is also one of the more powerful of the hydropathic appli- 
ances, and needs judgment in its use. It consists, in fact, of a vast 
number of small streams or douches, and hence is a powerful refrig- 
erant, as well as excitant, to the system. It is useful to commence 
this bath, for a time at first, only upon the limbs. 

The Cataract Bath. 

This also is one of the more powerful of the hydropathic processes, 
and is to be classed with the two preceding baths. Like them it may 
be said to be stimulant, tonic, and alterative, while it is also highly 
sedative as far as animal heat is concerned. 

The Hose Bath. 

Through the modern improvements in India-rubber, gutta percha, 
leather, etc., it is easy, whenever there is a small fall or head of water, 
to arrange what is called a hose-bath. It is in principle a douche, 
with the additional advantage that it can be made to act upon any 
part of the body, and from whatever direction we choose. Rightly 
applied, the hose bath is a valuable remedy. (Fig. 181.) 



Fig. 180. 



Fig. 181. 





The Pail Douche. 

The process which passes under this name is taken thus: The 
patient seats himself in an empty, shallow, or other bathing tub, and 
crosses his hands over his chest. As many pails of water as are or- 
dered are then dashed over him suddenly, one after another, before 
and behind alternately, — not poured, but thrown with some force, by 
first a backward and then a forward motion of the pail. 

A better method of using it is, for the patient to stand in an empty 



PROCESSES OF THE HYDROPATHIC TREATMENT. 533 

bathing tub, while an assistant takes two pails of water, one ten de- 
grees warmer than the other, and empties the warmer half upon the 
chest and half upon the back, and then bestows the colder pailful in 
the same manner ; then dries with friction. 

The Wave or Sluice Bath. 

This is taken at the sluice-way of an undershot mill-wheel, or in 
any similar place. The patient takes hold of a rope, or something by 
which he can maintain his position, and then, lying down, subjects 
his body to the action of the water. This is, on the whole, a pleasant 
and agreeable bath, and in its effects somewhat resembles the douche, 
being, however, milder and safer. 

The Half Bath. 

This bath may be used as one of the mildest of the water-cure 
processes, or as one of the most powerful. An ordinary bathing tub is 
a very good apparatus for the purpose. A good sized washing tub 
will answer very well, if there is nothing else at hand. The water 
should generally be quite shallow in this bath, — from three to six 
inches. Priessnitz's half-baths were made of wood, four or five feet 
long, about two and a half feet wide, and twenty inches deep. This 
simple contrivance is one of his most powerful remedial means, — 
that by which some of his highest triumphs are achieved. 

The water is generally used of moderate temperature, at sixty to 
seventy degrees Fahr., and, when long continued, is changed, as it 
becomes warm from the heat of the body. 

This bath may be used. 

First, as a means of cooling the mass of the circulation in the hot 
stages of fever, and in inflammatory attacks of every kind ; 

Secondly, as a revulsive, or means of drawing blood in congestions 
or inflammations of the nobler organs, the brain, lungs, stomach, 
liver, etc. 

Thirdly, as a means of resuscitation in the shock of serious acci- 
dents, sun-stroke, and before, during, or after apoplectic and other fits. 
In drunkenness and delirium tremens, the half bath is a sovereign 
remedy ; 

Fourthly, as a middle means, and preparatory to the general bath 
in weak constitutions. 

In the latter of these indications, the bath is generally used but for 
a few minutes after the wet sheet, or at other times, as may be de- 
sired. In the former, much practical knowledge is necessary in order 
to proceed always with safety, and to obtain the best results. Thus, 
six, or even nine hours may be required, with the greatest persever- 
ance, the patient being thoroughly rubbed over the whole surface, and 
this to be kept up constantly by relays of assistants, the patient's head 
and shoulders, meanwhile, being supported. 



534 



PROCESSES OF THE HYDROPATHIC TREATMENT. 



The Plunge Bath. 

Ix sea, river, and lake, as well as by artificial means, and as a 
matter of luxury, religious observance, purification, and the preven- 
tion and cure of disease, the plunge bath has, in all periods of time, 
and in all parts of the world, been a favorite resort. So efficacious, 
indeed, has this simple means proved in healing the sick, that not a 
little superstition has been mingled with it. Springs and wells have 
often been supposed to possess some mysterious power, and for that 
reason been named after some patron saint. In this respect, the 
world has loved mystery and marvellousness rather than the pure and 
simple truth. 

In hydropathic practice, the plunge is much used ; but many pa- 
tients are not able to bear it. Those who are not sufficiently strong 
for it at first, should practise the rubbing wet sheet, the half-bath, 
drinking, exercise, etc., until the plunge can be borne. It is a favorite 
remedy at all the establishments, to be taken directly on coming from 
the wet sheet pack. 

The Head Bath. 

From time immemorial, cooling applications to the head have been 
much depended upon in that violent and dangerous disease, inflam- 
mation of the brain. All other known means failing, certain obsti- 
nate affections of the head have been known to give way to affusion 
of cold water upon the part. In headache, drunkenness, delirium 
tremens, the delirium of fever, epilepsy, rheumatism of the head, dis- 
eases of the eye, earache, deafness, loss of smell and taste, and in 
nose-bleed, this highly energetic remedy is brought to bear. In taking 
it, the patient lies down, placing the back of his head in a shallow 
dish J filled only an inch or two with water. (Fig. 182.) 



Fig. 182. 



Fig. 183. 





The Leg Bath. 

This is useful in cases of ulcers, swellings, eruptions, gout, rheu- 
matism, sprains, wounds, etc., of the leg or thigh. The relief and 



PROCESSES OF THE HYDROrATHIC TREATMENT. 535 

strength obtained, often by a single application of this remedy, is truly 
wonderful. A variety of apparatus may be contrived for administer- 
ing the leg bath. A common wooden tub, contrived for the purpose, 
like that represented in Fig. 183, answers a good purpose. In such a 
vessel, he covers the inflamed limb introduced, and cools the blood 
flowing to it. 

The Sitz-Bath. 

Convenient tubs, wooden or metallic, are constructed for this bath; 
but an ordinary wash-tub answers very well. The vessel should be 
large enough to permit the motion of the arms in rubbing the abdo- 
men, sides, and hips, first with one hand, and then with the other. 
Water enough should generally be used to pretty nearly cover the 
belly. The more movement and friction while in this bath, the better. 
It is more conveniently administered when the tub is elevated two or 
three inches from the floor. Some undress the patient completely, 
and place a blanket or sheet over the upper part of the body ; but 
oftener, only those parts are micovered which are to be exposed to 
the water. (Fig. 184.) 

In a variety of ailments, this bath is highly valuable. It may be 
made one of the most powerful of all the hydropathic modes. Like 
all other powerful applications, it should be taken only when diges- 
tion is nearly or quite completed. 

As a tonic to the stomach, liver, bowels, womb, spine, etc., this 
bath is highly useful. In constipation, and other irregularities, it is 
famous. Those of sedentary habits will find its use of rare service. 
For the tonic effect, ten, twenty, twenty-five, or thirty minutes. If 
continued for some length of time, the water is to be changed once 
or more, as it would otherwise become too warm. 



Fig. 184. 



Fig. 185. 





The Wash-Tub Bath. 

Under a great variety of circumstances, the wash-tub bath is as 
invaluable remedy. For example, a patient is feverish ; by setting 



536 PROCESSES OF THE HYDROPATHIC TREATMENT. 

him in a wash-tub half filled with water, and, at the same time, if we 
choose, putting his feet in a pail of water, cold or warm, according to 
the case, we may give him any desirable amount of cooling. We 
cannot, indeed, too highly prize this simple contrivance for using 
water, — a means which every family possesses. (Fig. 185.) 

The water, as a general rule, should be tepid, ranging from 72° to 
90°, and may be prolonged from two to fifteen minutes, according to 
the strength of the patient. It should never be carried to the extent 
of producing blueness of the nails. The patient should be dried with 
towels, or the dry rubbing sheet. 

This bath is useful in the treatment of eruptive fevers, bilious re- 
mittents, the hot stage of intermittents, and in hectic and typhoid 
fevers. It is often used after the wet sheet pack, in chronic affec- 
tions, and may then have a little cooler temperature, or else be fol- 
lowed by pouring a pail of cooler water over the shoulders, to tone 
up the skin. 

The Affusion. 

The patient stands in a wash-tub, bathing-tub, or other convenient 
place, when, by means of a pail, pitcher, or basin, the assistant pours 
water upon the head, neck, etc., either upon the whole of the body or 
only upon a part. The water is used in quantity and temperature 
according to the necessities of the case. The affusion is one of the 
best of hydropathic modes. 

Fifty years ago. Dr. Currie, of England, performed great cures in 
fever by the affusion, sometimes tepid, at others cold, according to the 
strength and heat of the patient. If there was great heat, the water 
was used cold ; if not, the reverse. In a variety of febrile diseases, 
such as typhus fever, scarlet fever, small-pox, measles, tetanus, con- 
vulsions, etc., he used this remedy with remarkable success. 

Towel and Sponge Bath. 

With one or two coarse towels and a quart or two of water we 
may take a very good bath almost anywhere, even in a carpeted 
room, at a hotel, or Avherever we may be, without spilling a drop of 
the water. After a person becomes accustomed to this form of ablu- 
tion, none but the most indolent will be willing to do without it, 
unless they can have some other form of bath. A daily towel ablu- 
tion, thoroughly performed, is an excellent prevention against colds, 
helps the appetite and digestion, and is a good means of preventing 
constipation. 

Some are in the habit of sitting in a half-bath or a sitz-tub, and 
w4th a large sponge making the water pass freely upon the head, neck, 
shoulders, and other parts of the body. At the same time, the bather 
may pour water from a cup, basin, or pitcher, upon the head, neck, 
etc. This is a mild affusion, and stronger in effect than the towel- 
bath. 



PROCESSES OF THE HYDROPATHIC TREATMENT. 537 



Wash-Down. 

The process to which this name is given by Dr. Edward Johnson, 
is practised as follows : " The patient stands in an empty sitting or 
wash tub, beside which stands a pail of cold water with two coarse 
towels soaking in it. The bath attendant, taking his place behind the 
patient, lifts one of the towels, all loaded with water, and lays it 
quickly on the patient's Kead. The patient immediately seizes it, 
removes it from his head, and rubs himself rapidly with it, — his face, 
his Throat, shoulders, arms, chest, stomach, bowels, thighs, and legs. 
Having gone rapidly over the whole body once, he drops his towel 
into the pail again, which the bath-man presses down to the bottom 
of the water, then lifts it out, and places it on his head again. As 
before, the patient seizes it, and goes all over the same ground once 
more, and then drops it into the water again, when the bath-man 
again lifts it and places it on the head to be a third time removed by 
the patient, and applied as before, rapidly, actively, and energetically, 
all over his body in front. The bath-man is industriously occupied 
all the time behind in the same manner, from the back of the neck to 
the back of the legs, wetting his own towel as often as he wets that 
used by the patient, viz., three times. This is called a wash-down of 
three towels. The patient is then dried in a dry sheet. It is a more 
powerful bath than the common towel-bath, but not in all respects so 
convenient to take. 

The Cold Foot-Bath. 

One of the first things people who are troubled with cold feet do, is 
to plunge them into cold water. Nor is the assertion, put forth in 
some of the hydropathic works, that the cold foot-bath was prescribed 
by Priessnitz for the same purpose that the faculty order warm ones, 
correct. When the feet are already cold, neither Priessnitz nor any 
one in his sober reason would prescribe cold water, which can only 
make the parts colder. To obtain the good effect of the cold foot- 
bath, so far as the feet are concerned, they should be warm whenever 
it is taken. For a tendency to coldness of the feet, — a very common 
symptom in these days of so-called luxury and refinement, and one 
that indicates a state of things in the system incomparably more to 
be dreaded than the mere coldness of the feet, — this is the remedy. 
It may be taken at any convenient time ; just before the morning 
walk is a very suitable occasion, the parts being usually warm early 
in the day. 

At other times, if cold, they should, if at all practicable, be warmed 
by exercise and friction, before subjecting them to the action of cold 
water. But in cases of old age, great debility, etc., the warm foot- 
bath, and other warm applications may be resorted to before the cold. 
Thus with cold, exercise, and friction, accustoming the feet daily and 
frequently to cold water, will beget in them a habit of remaining 
warm. In a great variety of ailments, such as toothache, rush of 

68 



538 PROCESSES OF THE HYDROPATHIC TREATMENT. 

blood to the head, headache, earache, inflammation of the eyes, gout, 
rheumatism, hemorrhages, etc., the cold foot-bath is a valuable remedy. 
It is ordered deep or shallow, and of duration according to the nature 
of the case. 

Wading Foot-Baths. 

I HAVE often directed patients to wade in water in some convenient 
place, as a means of hardening the system and of giving tone to the 
nerves. Delicate ladies who were not able, as they supposed, to en- 
dure cold water applied to the feet, have by degrees, wetting the feet 
but little at first, become so accustomed to the coldest water, that in a 
few weeks they could bear as much as any one would desire. Caution 
and perseverance should be the rule. 

It is partly by sympathy and partly by the abstraction of heat, that 
foot-baths and wetting the feet act in so beneficial or deleterious a 
manner as we know them to do. The principle of sympathy is an old 
one in the medical art, but none" the worse for that. 

The Warm Foot-Bath. — Pediluvium. 

I AM aware that some who consider themselves genuinely hydro- 
pathic^ object to the use of this remedy. Having truth for my object, 
however, I care not for such objections so far as myself am concerned, 
and without stopping here to argue the question, I simply remark that 
ivarmth under some circumstances is as natural an application for the 
living body, as cold under other circumstances. I have already re- 
marked, under the head of the cold foot-bath, that putting the feet into 
warm water is often a good preparatory process to that bath. It is 
good also, now and then, for soothing divers aches and pains, and also 
for warming the feet of old and weakly people, who cannot exercise 
sufficiently. 

The Nose-Bath. 

In a variety of nasal ailments, catarrh, colds in the head, inflamma- 
tion and ulceration of the nasal passages, nose-bleed, etc., the nose- 
bath is a salutary remedy. The water is used either tepid or cold, 
according to the case. It should be drawn back if possible, so that it 
is ejected by the mouth. Those who have injured the nasal cavities 
by much snufl'-taking, will find advantage from sniffing water freely 
into the nostrils. If one is determined to leave off snuff, as every one 
addicted to it, if he regards either health or bodily comfort, ought, 
he will find it useful often to take cold water, instead of the abomina- 
ble weed. 

The Eye and Ear Bath. 

Various contrivances may be brought to bear in applying water to 
the eye and ear. Light, ascending douches and showers are useful in 



PROCESSES OF THE HYDROPATHIC TREATMENT. 539 

various diseases of the parts. There should not be much force used 
in this way. Immersing them also in water is often useful. The 
water should not, in general, be very cold, tepid or warm being often 
.^ the best. 

Mouth, or Oral Bath. 

For inflammation of the gums, mouth, throat, and palate, in slimy 
secretions from the throat and stomach, in toothache, catarrh, colds, 
and chronic hoarseness, garglings and baths for the mouth are of great 
service. Pauley, a merchant of Vienna, has been thought singular 
for his zeal in recommending this bath. Clergymen and others who 
sutler hoarseness by much speaking, will find that holding very cold 
water in the mouth until it begins to grow warm, and then ejecting it, 
and by frequently repeating the process, much benefit will be obtained. 
Coughs and tightness of the chest may often be essentially relieved 
by this 'bath. In mucous secretions from the throat and stomach, by 
ejecting the water a number of times, it will surprise those who have 
not witnessed the remedy to see the amount of slimy secretion thrown 

Division of Baths. 

On no one subject connected with hydropathy has there been more 
"confusion of tongues," than concerning the temperature of baths. 
Both in books and in popular language, among physicians as well as 
laymen, have words been used, sometimes confusedly, and at other 
times without any meaning whatever. Orthodox medical works, as 
well as the i/«orthodox, come under the same category of error. A 
few simple explanations on this head, properly made, will be sufficient 
for all practical as well as scientific purposes. 

The simplest and most natural division of baths is into cold^ tepid, 
warm, and hot. These are all terms of every-day life, and are fully 
sufficient to guide us in the selection of any and all the multiform 
uses of water which hydropathy teaches. I admit, however, that 
when we wish to be especially explicit, the actual thermometrical 
temperature should be mentioned. Hot baths, I maintain, have no 
proper place in hydropathic practice. He who resorts to them either 
does not at all understand the true principles of the Water- Cure, 
or is guided merely by the whims or caprices of those who employ 
him. 

But whatever words we use to designate the different baths, there 
is one objection, which is, that all such terms are necessarily arbitrary 
in a greater or less degree. What appears to one person cold, may 
to another appear tepid, or warm, or even hot. Thus it is said that 
on a road over the Andes, at about half way between the foot and 
the summit, there is a cottage in which the ascending and descending 
travellers meet. The former, who have just quitted the sultry valleys 
at the base, are so relaxed, that the sudden diminution of temperature 
produces in them a feeling of intense cold ; while the latter, who left 



540 PROCESSES OF THE HYDROPATHIC TREATMENT. 

the frozen summit of the mountain, are overcome by distressing sen- 
sations of extreme heat. If on a cold winter's morning we go from a 
warm bed to a bath of sixty to seventy degrees Fahr., the water ap- 
pears cold. If we then plunge immediately into water which is at 
about the freezing point, and then return again to the water at sixty 
to seventy degrees Fahr., it appears warm. When the temperature 
of the atmosphere is at fifty-five degrees Fahr., in November or Octo- 
ber, in this latitude, and the body of a comfortable degree of warmth, 
and we take three basins of water at sixty, seventy, and eighty de- 
grees Fahr., placing one hand in the water at sixty degrees, the other 
in that at eighty degrees, letting them remain thirty seconds in each, 
and then immerse them both in the water at seventy degrees, it ap- 
pears to one cold^ to the other warm. 

But we can arrive at rules which approximate so nearly to the ac- 
tual truth, that they will serve us, as before remarked, for guides in 
all practical and scientific purposes. 

The Cold-Biitli. — With a majority of persons, and at most seasons 
of the year, water at from seventy to eighty degrees Fahr. downward, 
gives, when immersed in it, a sensation of coldness. The spring water 
of all countries furnishes what may therefore be called a cold-bath, 
although there will be a range of many degrees variation in what we 
term cold. 

The Tepid-Bath. — The word tepid is from the Latin tepeo^ to be 
warm. The true English meaning of the term however is, according 
to Mr. Webster, moderately warm^ or lukewarm. ; in other words, water 
which, when a person is immersed in it, gives a kind of indefinable 
sensation, one which, coming properly under the neither cold nor ivarm, 
is said to be tepid. This temperature will be found to range at from 
eighty to ninety-two degrees Fahr. 

The Warm-Bath, — The term warm is generally well understood. 
It means that temperature of water which is peculiarly agreeable to 
the sensations. Fresh-drawn milk or blood we say are warm. The 
temperature of water which will cause this sensation, varies from 
ninety-two to ninety-eight degrees Fahr. 

The Vapor-Bath. — The temperature of the vapor of simple water 
varies from about ninety degrees Fahr. upward, according to the heat 
of the water, and the space through which the vapor passes. 

The Hot-Bath. — The term hot is also expressive of its proper mean- 
ing. If the body is immersed in water above blood-heat, it causes an 
uncomfortable sensation, which we designate as hot. Hot water is a 
disturber of the vital functions, particularly if the whole body is im- 
mersed in it. Hot-baths, therefore, should be used, if ever, only in a 
most urgent necessity. Hot water, in no form whatever, entered into 
any part of Priessnitz's treatment. 

Having thus explained the temperatures of the different divisions 
of the bath, it is proper to state them in a tabular form, the better to 
aid the memory. They are as follows : 



PROCESSES OF THE HYDKOPATHIC TREATMENT. 541 

Cold-bath from freezing point, . . 32 to 85° F. 

Tepid - 80 to 92° 

Warm " . . . . . . 92 to 98° 

Vapor " 90° and upward. 

Hot " above 98° 

I now propose to explain somewhat minutely, and at the same time 
with a due regard to the needs of the non-professional reader, the 
physiological efiects of each of the several kinds of bath, and I here 
respectfully premise that any one who attempts to practise the water 
treatment without having in his mind clear notions upon this subject 
is, to say the least, as much a " groper in the dark" as he who attempts 
the practice of drugs of which he knows nothing, upon the living body 
of which he knows less. How can a man be trusted in water treat- 
ment if he cannot tell beforehand what effect a bath is to have ; and 
this he cannot, if he does not fully understand the meaning of the 
terms which I have here explained. 

Effects of the Cold-Bath, — The effects of the cold-bath are properly 
spoken of under two heads, the primary and the secondary. The 
terms are sufficiently expressive of their meaning. The first are 
those which take place at the time of the immersion ; the second, 
those that occur later, constituting what we understand by the term 
reaction. 

Immediately on immersion in cold water, the bather experiences 
some acceleration of respiration and the heart's action, although the 
pulse becomes at the same time smaller and weaker. Very soon, 
however, the panting^ if I may so call it, passes off; the temperature 
of the body is found diminished, the surface paler than natural, the 
skin taking on that form of appearance known as "goose-flesh." 

The first effect of cold water applied to the body, generally, is to 
abstract a certain amount of heat from the surface, to constringe the 
capillary vessels, and to force the blood inward. Now, as the living 
body possesses the remarkable, property of maintaining its tempera- 
ture at very nearly the same point, whether it is in a colder or hotter 
medium than itself, the vitals at once set to work in restoring the 
caloric abstracted by the contact of the water ; and as the functions 
of circulation and calorification go necessarily together, the vital 
power, acting through the heart and blood-vessels, attempts a return 
of the blood that had been forced inward by the coldness of the 
water. 

This is what we call reaction. If the individual is sufficiently 
strong and well stocked with vitality, the blood is quickly returned 
to the surface and to the extremities (which are always most liable 
to become cold, being farthest from the heart), constituting what is 
termed good^ or vigorous reaction. But if the surface and extremities 
continue to remain unwarmed by this return of the blood to them, as 
happens in the case of feeble persons, there is said to be poor^ or in- 
sufficient reaction. 

Effects of the Tepid-Bath. — The tepid-bath, which we have seen 
ranges from eighty to ninety-two degrees Fahr., produces effects anal- 



542 PROCESSES OF THE HYDROPATHIC TREATMENT. 

ogous to those of the cold-bath, only not so lasting and permanent. 
It is especially useful in the treatment of infants and children, and in 
all cases where the reactive energy is feeble. If in any case we are 
in doubt as to whether the cold bath is admissible, the tepid form will 
be a milder measure, and at the same time serve as a test in ventur- 
ing upon the cold. The tepid bath may be continued longer at a 
time, which in some cases will be found an advantage. 

Effects of the Warm-Bath. — There is among hydropathic physi- 
cians, if I am not mistaken, too great a fear of warm applications on 
the part of some, while others go to the opposite extreme. Mark, I 
speak of warm applications. Hot^ as before remarked, have no proper 
place in hydropathy, — a rule to which the exceptions are few. 

The warm-bath, as before remarked, ranges from ninety-two to 
ninety-eight degrees Fahr. It is not the most useful of the hydro- 
pathic resources, but one of the most useful, as I shall endeavor here- 
after to show. 

Among the ancient Romans the warm-bath was not considered as a 
means of luxurious indulgence that tended to weaken the vital powers, 
but a means of refreshment for the wearied traveller, and of prepar- 
ing him for the repast and the enjoyment of other rites of hospitality. 
The effect of the warm-bath is not one of debility, as many suppose, 
but, on the contrary, it is a sedative, lowering the heart's action and 
the circulation, and tending to repose rather than excitement. 

Effects of the Hot-Bath. — The hot-bath, before remarked, is one 
which is above the temperature of the blood, ninety-eight degrees 
Fahr. It was laid down as a precept by Hippocrates, that a bath en- 
feebles when the heat exceeds that of the body immersed in it. The 
truth of this precept has often been verified in practice. 

I do not wish to be understood as affirming that hot applications 
can never be made with benefit to the body ; on the contrary, heat 
applied to a part locally may be of service, although I am inclined to 
believe that even in those cases where heat acts in a beneficial way, 
some other form of hydropathic appliance can be used more benefi- 
cially. I make, it will be remembered, a broad distinction between 
the terms hot and warm. 

Sea-Bathing. 

As regards temperature, sea-bathing comes under the general head 
of cold-baths. Sea water, however, at those seasons of the year when 
sea-bathing is resorted to, is of but a moderate degree of coldness, 
varying in this latitude not much from seventy degrees Fahr. 

In order to appreciate fully the effects of sea-bathing upon the sys- 
tem, a number of things are to be considered. 

Sea water differs in its effects from common water by its possessing 
greater density. This circumstance, however, is not of so great im- 
portance as that of the stimulating nature of the mineral it contains. 
The saline ingredient is a powerful stimulant and even irritant of the 
skin. On account of this property, it is foun(J that an exposure to the 



TROCESSES OF THE HYDROPATHIC TREATMENT 543 

action of salt water is not so liable to cause ill effects as that to fresh. 
The salt causing a degree of heat upon the surface somewhat higher 
than that of the natural state, the system is for the time shielded from 
the action of cold. It does not follow from this, however, that a per- 
son could live longer immersed in sea than in common water, any 
more than it follows that because alcohol for a time increases the 
animal temperature, life can, under circumstances of great exposure 
to cold, be the longer preserved. This it is now well known is not 
the case. 

An advantage of sea-bathing in the hot season is, that the air at 
the sea-shore is cooler than on land. That our climate in summer is 
too hot for the most favorable development of health is proved by 
the great increase of mortality, not only in our cities, but in other 
parts, during the hot season. The European cities, with all their 
numbers of inhabitants, dampness, narrow streets, intemperance, pau- 
perism, etc., would naturally be expected to show a higher range of 
mortality than our American cities, but such is not the fact. Even 
New York, with all its natural advantages, is as sickly, probably, as 
any of the British or European cities. This, it is agreed on all 
hands, must be owing in great part to the great heat of our summer 
months. 

The manner of taking the salt-water bath has some peculiarities 
which are favorable to health. It is, in the first place, in the open 
air, which, if the weather is favorable, that is, neither too hot iior 
cold, is always a great advantage. Other things being equal, a bath 
in the open air is always attended with a better reaction and a greater 
degree of invigoration than one within doors. 

In the second place, sea-bathing is usually and almost necessarily 
connected with exercise both before and after the bath, circumstances 
which are always highly favorable to the action of cold water. So 
beneficial, indeed, is exercise taken in this way, that it would be diffi- 
cult to determine which of the two, — the exercise or the bathing, — 
is the more beneficial. In connection, the two act reciprocally upon 
each other, each rendering the other doubly beneficial. 

Injections. 

The term injection implies the act of throwing a fluid into some 
cavity of the body. 

In Water-Cure we inject water more frequently into the bowels 
than any other cavity. This kind of injection is also called eneina^ or 
clyster. 

Most people have so little confidence in simple water, that if a 
clyster is administered to them, they have no idea that it can operate 
in so effectual a way as it usually does. Years ago, when the water 
treatment was much less known than at the present time, I have been 
suspected of having secretly put some cathartic substance in the 
water, " for," said the patients, " how is it possible for water to act in 
this way ? " 

A great variety of injection-instruments have been invented. Some 



544 PROCESSES OE THE HYDROPATHIC TREATMENT. 

of these are very convenient and useful ; others are got up on mere 
speculation, and are but little worth. Every family, at least, ought 
to have a good force-pump injection-instrument, if they can obtain 
such a one. A lady's toilet is never complete without it. A good 
article is either manufactured or sold by most surgical-instrument 
makers, and druggists often have a good article. But heiuare of im- 
position. It is better to get along with a common bladder and goose- 
quill, as we may in an emergency, than to pay for a good-for-nothing 
syringe. 

Modus Operandi of Water. 

It is often objected to hydropathy that water, being but one agent, 
cannot be made useful in all diseases. I propose here to make some 
remarks on the modus operandi of ivater, in which I shall endeavor to 
explain, not only to the scientific scholar, but to the ordinary reader, 
that water is capable of being made available as a remedy, — and that 
powerfully too, — in a great variety of ways. It then acts : 

1. By its Presence. — Water, as we have seen elsewhere, composes 

the larger part of the living body; and that without its presence in a 
large proportion in the living system, the vital processes cannot for a 
moment go on. 

2. By its Coldness. — Cold, within proper limits, preserves and aug- 
ments life, while heat tends to debility and decay. In proportion as 
the animal heat is diminished in the different classes of animals, the 
less is the want of air felt. If in a puppy the eighth pair of nerves 
be divided, producing a closure of the glottis so that no air can enter 
its lungs, the animal dies in half an hour, if kept at an ordinary tem- 
perature. But if the animal is benumbed with cold it survives the 
operation for a whole day. Frogs, in the summer, when the tempera- 
ture of water is elevated, are obliged to come often to the surface for 
air. But in winter, when the water is colder, they live almost entirely 
under its surface. A cholera patient in collapse, a person who has 
been stifled by foul gases, one in the sinking stage of a fever, or faint- 
ing from loss of blood, or in any way asphyxiated, desires always 
coldness rather than heat. It may not be possible in the present 
state of science to explain these phenomena ; but undeniably we have 
the facts. 

3. By Endosmose and Exosmose. — Animal membranes have the 
power of absorbing" liquids, — called endosmose, or imbibition, and of 
throwing them out, exosmose, or transudation. 

If we take a portion of the intestine of a chicken, tie one end, 
nearly fill it w4th milk, then tie the other end, and lastly immerse it 
in a tumbler or other vessel of pure water, we find that in a short 
time the milk passes out of the intestine into the water, and the water 
inwardly mingling with the milk. This process goes on till the fluid 
within and without the intestine becomes one and the same. This is 
a familiar illustration of the principle in question. 



PROCESSES OF THE HYDROPATHIC TREATMENT. 



545 



4. By Dilution, — Water is the greatest diluent in nature. There 
is no substance which is at all comparable to it for penetrating the 
myriads upon myriads of capillaries that exist in all parts of the 
living structure. 'When the fluids become thick, viscid, and filled with 
impure matters, as is usually the case to a greater or less extent, in 
disease, it is an important object to dilute these matters. For this 
purpose water is the only available remedy. 

5. By its Tonic Effect, — Water is the greatest of all tonics, and 
possesses the valuable property, not of wearing out, but of increasing 
in its good effects. 

6. By its Excitant or Electrical Power. — A man feels dull and 
stupid from excessive bodily or mental labor, from excessive alimenta- 
tion, or spirit, or tea and coffee drinking, with the blood all crowding 
up into his head. We apply the well-wrung rubbing wet sheet one, 
two, or three times, to his surface, according as he may need, and he 
at once perceives a most wonderful change for the better. Or a man 
feels of a morning dull and stupid, with his muscles sore ; he has 
the rubbing wet sheet, the plunge, shower, or douche, and instantly 
his troubles banish. Or he may have a lumbar abscess which has 
run him down so low that when he wakes in the morning he finds 
he cannot walk. Two or three gallons of cold water are poured over 
him, upon which he walks readily. Now these effects of water, 
remarkable as they are, arise simply from its excitant or electrical 
power. 

7. By its Temperature, — In acute disease, in all fevers and inflam- 
mations, of whatever name or grade, the great power of water to 
regulate the temperature of the body is one of the most striking of 
all the phenomena cognizable by man. By the use of cold water we 
can always vary the heat of the body and the velocity of the heart's 
action to any desirable extent. 

8. By Purifying the Blood. — Water accomplishes one thing which 
no drug, no other substance in nature can. It purifies the blood. It 
does this because it penetrates every lane and alley of the system, 
however minute. No capillary is so delicate that it does not pene- 
trate its smallest possible part. It purifies the blood, because as long 
as the vital principle lasts, the tendency of nature is to preserve the 
vital fluid in a healthy state; and penetrating every tissue of the body 
as water does, it assists nature in the purifying process as no other 
substance can. * 

9. By Augmenting the Vital Force. — No fact in science is better 
established than that water possesses the power of actually increasing 
the amount of vitality in the system. This is, in fact, the prime 
effect of water. It aids the system in throwing off* disease in the 
same way that increasing a merchant's capital aids him in throwing 
off* debt. 

The foregoing propositions are submitted as elucidating some of 
the leading principles concerned in the action of water upon the living 



546 PROCESSES OF THE HYDROPATHIC TREATMENT. 

body. I do not claim, however, that the whole of the philosophy of 
the effects of water is yet understood by any one. Doubtless those 
who know most about it have yet much to learn. 

Rules for Using Water. 

The Time of Day. — In general, the more powerful applications 
should be made in the early part of the day. At this time the calor- 
ific powers and the circulation are more vigorous, and, consequently, 
the body more able to resist powerful applications of whatever kind. 

The Meals, — Ordinarily, no powerful bath should be taken within 
three to four hours after a meal. A full stomach and cold water do 
not at all agree. But in certain diseased conditions, as feverishness, 
inflammation, colic, cramp in the stomach, cholera morbus, and other 
sudden attacks, water appliances are to be commenced without refer- 
ence to hours or meals. The symptoms then are our only guide. 

The Lighter Baths. — If there is doubt as to which application to 
make, the well-wrung rubbing wet sheet, the tepid shallow-bath, or a 
warm-bath should first be taken. 

• Reaction, — "Within a reasonable time after a bath, the body in all 
its parts should become naturally warm. If the feet and hands re- 
main cold, and the nails and lips blue, the bath has, to say the least, 
done no good. In some cases of fevers and other inflammatory dis- 
eases, it is better to keep the body chilly than to allow it to become 
too warm. 

Ulceration, — If any part of the body, as the extremities, lungs, 
bowels, etc., is undergoing any considerable ulceration, very cold 
baths are inadmissible. 

Nen'onsness. — With some persons who are highly nervous, and 
particularly with nervous females, much cold bathing, although it ap- 
pears to agree well, and to be the best for a time, is in the end harm- 
ful, rendering the nervousness and general debility worse. 

Exercise, — For the douche, plunge, cold sitz, and foot baths, and 
all others that abstract a large amount of caloric from the system, the 
body should be fully warm, and the circulation somewhat accelerated 
by exercise. Exercise should also be taken after the bath, until the 
heat and circulation are fully restored. But if exercise is impractica- 
ble either before or after the bath, friction should be made to take its 
place. 

Increased Heat, — Elevation of temperature constitutes no objec- 
tion to bathing, provided the body is not excessively fatigued. The 
reason why overheated persons sometimes lose their lives by plunging 
into or drinking largely of cold water is, that the vital force has been 
too much exhausted. Mere heat is an advantage. 

Perspiration. — Neither does this constitute an objection to bathing 
or water-drinking, if the foregoing rules are observed. 



PROCESSES OF THK HYDROPATHIC TRExVTMENT. 547 

The Air. — Bathing in the open air is always preferable to in-doors, 
provided the extremes of heat and cold are avoided. 

The Head. — It is well always to wet the head with cold water, 
both before and after a bath. Douches and the shower should never 
be taken on this part. Simple pouring or aft'usion is the only mechan- 
ical force of water that should be allowed on the head. 

Preg'naucy. — This, as abundant experience proves, forms no objec- 
tion to bathing, or any form of properly regulated water treatment. 
Cold bathing and water drinking are of the greatest service during 
this period. 

Tlie Season. — If the lungs are not extensively diseased, and if there 
is no considerable ulceration going on in any part of the system, the 
cool and cold seasons are preferable for a course of bathing. With 
right' management, a patient gains two or three times as much in a 
given time during the cold months as he does in the hot. 

Days of Rest. — One day in seven water treatment should be dis- 
continued, with the exception of a simple ablution in the morning. 
Six days' treatment in the week is worth more than seven, because it 
is a law of nature that, if a remedy is continued steadily and without 
change, it loses much of its good effect. This is as true of water as 
of any other agent. Those who do wisely will omit the treatment on 
Sunday, whatever their religious convictions may be. 

Internal Use of Water, — The same general rules apply here as in 
the external applications. Thirst should for the most part be grati- 
fied whenever it is experienced. As a rule, the less water drank at 
meals the better. For the tonic effect, it is to be taken while the 
stomach is empty, and it is better that exercise should accompany it. 
From six to twelve tumblers per diem is a fair allowance for average 
patients. 

. Quality of Water. — For all remedial as well as hygienic purposes 
water should be as pure and soft as can be obtained. With proper 
care and ingenuity in the construction of cisterns, filters, etc., this 
desirable end can be everywhere accomplished. Lead, and lead 
pipes, should be avoided, except where the water runs freely and 
constantly. 

The Sweating Process. — Formerly it was much in vogue to sweat 
patients in the blanket pack, but latterly the practice has quite gone 
into disrepute. For several years of the latter part of Priessnitz's 
career he was very averse to using the process. It was a remark of 
his, that the cures by sweating were not permanent. 

Wet Bandages and Compresses, etc. 

These, as we have already seen under the head of wounds and in- 
juries, are of great value in water treatment. They are used of any 
desirable size, upon any part of the body, and produce different effects 
accordingly as they are used. Cooling' wet compresses are such as 



548 PROCESSES OF THE HYDROPATHIC TREATMENT. 

are changed or rewet frequently, and for the most are left uncovered. 
The warming or stimulating are covered and left upon the part until 
it becomes as warm or warmer than natural. Warm fomentations 
are useful in certain cases, but the hot should, as a rule, be discarded. 

The wet girdle is one of the most useful of all medical appliances. 
Two and a half or three yards of good toweling, with tapes arranged 
at one end, the corners of which have been turned over and sewed so 
as to form a point, forms a good girdle. It should pass usually three 
times about the body, one half having been wet. This brings two 
thicknesses of wet on the abdomen and one upon the back. At 
Graefenberg this application was worn by every patient, and, as a 
rule, all of the time. It is useful in a great variety of ailments, both 
acute and chronic. The same form of application is also useful for 
the arms, legs, etc., the tapes being used in preference to pins. 

The wet jacket^ or chest wrapper^ is also a valuable resort in diseases 
of the chest. Oiled silk and other similar articles, as I have elsewhere 
observed, are not to be used upon these local applications. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 



Choice of the Sick-room, etc. 

Sleeping Apartment, — In every case of disease, however slight its 
nature, the sleeping apartment of the sick should be airy and well 
ventilated ; but, when Providence visits any member of a family with 
disease of a serious and protracted description, all other considera- 
tions giving way to the necessity of the case, an apartment should be 
chosen and arranged in a special manner for the reception of the in- 
valid. It should be one calculated to administer to his temporary 
comfort, as well as to aid his recovery. It is not time, when the 
alarm is sounded and the danger is already urgent, to think of such 
arrangements ; forethought must be put in requisition ; every want 
anticipated ; and whatever is likely to be required should not only 
be provided, but so arranged that it can be instantly found when it is 
needed. 

The sick-room should be large, lofty, and, if possible, with a north- 
ern aspect, in Order to avoid the heat of the mid-day or the afternoon 
sun : the windows should be capable of being opened by drawing 
down the uppermost sash ; an advantage, however, which cannot 
always be obtained, as this mode of opening windows is too gener- 
ally neglected in the construction of modern houses. No room, how- 
ever large, should be used as a sick-room, unless it has a chimney ; 
but neither the chimney-board nor the soot-board of the apartment 
should be put up, even in summer. No article of unnecessary furni- 
ture should be permitted to remain in the room ; and that which is 
left in it should be of a description fitted to administer to the conven- 
ience of the invalid. 

Two tables are sufficient. One of them may be small, to stand 
near the bed, for the immediate use of the patient : namely, to hold 
his jug of barley-water, or toast- water, or other beverage ; — a small 
tea-pot, or, what is preferable, a half-covered cup with a spout, to 
enable fluids to be administered without raising the sufferer in bed; — 
his medicines for the day ; — and any other thing which he may fre- 
quently require. 

The other table should be large, for the accommodation of medi- 
cines not in immediate use, and also for spare glasses, jugs, cups, 

* Thompson, On the Management of the Sick-Room. 



550 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

spoons, both large and small, and other necessary articles. This table 
should have one drawer, at least, which ought to be furnished with 
the following articles : broad and narrow tape ; two or three half- worn 
ribbons ; a bundle of old, soft linen ; a sponge ; a few ounces of lint ; 
scissors, large and small ; a bone spatula for spreading ointment ; a 
couple of rolls of muslin, and the same quantity of flannel bandage 
two inches broad ; a pin-cushion well supplied with pins ; needles and 
thread ; and about half a yard of simple adhesive plaster. 

A Sofa or Recliuiiig' Chair, — A sofa, if the apartment be sufficiently 
large to admit of it, is a very important piece of furniture in the sick- 
room ; the erect or the sitting posture being injurious in many dis- 
eases ; and, when the sick-bed requires to be made, a sofa affords the 
means of removing the patient from the bed with as little inconven- 
ience to him as possible. 

]f there is not space for a sofa, there should be an invalid or reclin- 
ing chair ; and, when circumstances will permit, it should be of that 
kind which is susceptible of a variety of changes, so as to vary, at 
pleasure, the position of the patient. There should not be more than 
two other chairs in the room. If there is a looking-glass in the apart- 
ment, in a situation which admits of the patient seeing himself in it 
as he lies in bed, its place should be changed, or it should be alto- 
gether removed from the room. A chest of drawers is essential ; but 
none of the drawers should be appropriated for the reception of dirty 
linen, which ought never to be allowed to remain a moment in the 
sick-room. One draw^er should be specially allotted for towels, of 
which an ample supply is, in every case, necessary. The washing- 
stand will require two additional basins ; an additional water bottle 
and a tumbler ; and a large, supernumerary water jug, under the 
table, always full of water. 

]Vo Cooking in Sick-room. — There should be no kettle, nor any 
implement of cooking, in the sick-room ; even in winter, and when a 
fire is required. In general, a fire in the sick-room is only necessary 
for the comfort of the attendants ; but nurses too frequently take ad- 
vantage of it to boil the water for their own tea, and to prepare the 
slops for the invalid ; a custom which cannot be too severely repro- 
bated. The lamp termed a Night-nurse^ consisting of a water-bath 
placed over a lamp in a wire-worked cylinder ; a small tin kettle 
which enters the top of the cylinder ; and a covered earthen-ware 
vessel which fits it into the water-bath ; are useful for keeping fluids 
warm, and at the same time for preserving a light in the room, when 
an unshaded lamp or a candle would be hurtful. 

In continued fevers, the sense of hearing is often so morbidly acute, 
that ordinary sounds become causes of pain. In this case, if the floor 
of the sick-room be not wholly carpeted, every precaution to lessen 
the intensity of sound should be taken. One of the most effectual is 
to have a couple or more pairs of large list shoes outside the door, 
into which the feet, even of the doctors, may be advantageously 
thrust, when their shoes make a creeking noise, or when a visitor or 
nurse treads with a heavy foot. On the same account, when more 



DO^IESTIC MANAGEMENT OF THE SICK-ROOM. 551 

tlian one nurse or attendant is required to be in the room at the same 
time, no conversation, although it may be carried on in a whisper, 
should be permitted. Whispering, indeed, is apt to excite delirium, 
and to augment it when it is already present. 

Beds and Bedding*. — The French beds, without curtains, are those 
best adapted for the sick-room. When four-posted bedsteads, sur- 
rounded by curtains, were more in use than at the present time, the 
mischief arising from excluding the free air, by drawing the curtains 
close around the bed, was frequent and serious. In every case of 
disease, indeed, especially when it is attended by fever, the patient 
should be kept cool, and the most perfect freedom be given to the 
breathing : the mattress should be placed over the feather bed, and 
the pillows be firm and elastic. " The Marseilles coverlets, which are 
spread upon beds during the day, and often retained at night, are 
heavy, and calculated rather to increase than to subdue fever : conse- 
quently they should be wholly discarded from the sick-bed. Indeed, 
when the disease is fever, and when it is accompanied with great rest- 
lessness owing to the evening exacerbation, if the bed-room be suffi- 
ciently large, two beds should be placed in it ; or if two adjoining 
bed-chambers can be obtained, a bed ought to be put in each, so that 
the patient can be moved from one bed to the other every morning 
and evening. This both aids sleep, and it also tends greatly to insure 
the personal cleanliness of the patient. The bed-clothes of the bed 
from which the patient is moved should, on his removal, be immedi- 
ately turned down and fully exposed to the air ; a precaution which 
will set aside the necessity of so frequent a change of linen, as would 
be, otherwise, required. When there is only one bed, and when the 
disease is fever (unless the patient is too ill to permit his being 
moved), the sheets which have been used at night should be replaced 
by others in the morning, and hung up in the free air during the day, 
to be again used at night. But, when it can conveniently be done, 
in every case of continued fever, especially of an infectious kind, the 
sheets should be changed once in twenty-four hours ; a practice which 
is likely to prevent the fumes of infection from being communicated 
to the blankets, or to any of the furniture of the room. 

Ventilation is always of primary importance ; and that period, 
happily, is gone by, in which air was carefully excluded from the 
chambers of the sick, even when they were suffering under febrile 
disease. 

Ventilation is particularly demanded in those fevers in which mil- 
iary eruptions display themselves ; under no circumstances is it so 
essential as in febrile diseases of an infectious kind. It may, however, 
be consolatory to those whose duty it is to attend such cases, to know 
that infection, communicated through the air, rarely extends above a 
few feet from the body of the patient ; and even in the most malig- 
nant diseases, with the exception of confluent small pox, and malig- 
nant scarlet fever of the worst kind, its influence does not exceed a 
few yards, if the room be well- ventilated. On the contrary, if ven- 
tilation be neglected, the power of infection becomes greatly aug- 



552 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

merited from its concentration in confined and quiescent air ; it even 
settles upon the clothes of the attendants, and on the furniture of the 
room ; and these imbibe it most readily when their texture is wool, 
fur, or cotton, or any loose or downy substance capable of receiving 
and readily retaining the air. Smooth and polished surfaces do not 
easily receive or retain infectious matter ; consequently the nurses 
and attendants, in cases of infectious diseases, should have glazed 
gowns, and aprons of oiled silk. 

In no infectious diseases are these rules^more essentially necessary 
than in small pox and scarlet fever. It is well known that, if the bed- 
clothes of a patient laboring under either scarlet fever or small pox be 
closely folded up, they will r^ain the infectious matter, and commu- 
nicate the disease at a great distance of time ; but the influence of 
free ventilation is so great, that medical practitioners who are attend- 
ing small pox patients, and who go from them into the open air, do 
not spread the disease. Indeed, all infection is weakened by dilution 
with air. The danger of infection is augmented, if, along with bad 
ventilation, the atmosphere of the room be moist from any cause. 

It is further consolatory to know that the infectious matter, even 
of the most virulent description, is not poisonous to every one who is 
placed within the sphere of its influence. A predisposition of the 
body to receive the infection must exist before it can be communi- 
cated ; a condition which is augmented by fatigue and watching, de- 
fective nourishment, mental depression, or anything which can lower 
the vital powers. The necessity, therefore, of maintaining these pow- 
ers by attention to rest, a sufficient quantity of good and generous 
diet, and cheerfulness of mind, need not be insisted upon. 

In every case of infectious disease, the attendants, even in the best 
ventilated rooms, should stand on the windward, or on that side of 
the sick-bed from which the current of air comes ; as, by neglect of 
this rule, and by standing in the current which has passed over the 
patient, the infectious exhalations are blown upon them in a direct 
stream from the body of the patient. The attendants should never 
lean over the sick, nor should they receive their breath. The health 
also of the nurses should always be supported by nutritious and gen- 
erous diet ; but not by brandy, nor any other ardent spirit. 

The term infection in its most extensive signification, implies 
some deleterious matter, originating from any source, and transmitted 
through the air, which is capable of causing diseases in the human 
body. When this matter is emanated from the diseased bodies of 
men, the term is frequently regarded as synonymous with contagion; 
but, in strictness of language, the latter refers only to the communi- 
cation of disease by contact. Whatever may be the matter of infec- 
tion, it may enter the body through the medium of the lungs, which 
is the most ready inlet, or by the saliva, or even through the surface, 
if the skin be abraded, or if any ulceration be present. The influence 
of infectious matter is evidently exerted on the nervous system, dis- 
playing itself by debility, inertness, dislike to motion, great suscepti- 
bility of cold, irritability and despondency of mind, and by the pro- 
duction of a disease similar to that of the person from whom the 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 553 

■ ___ ►__ — __ 

infectious matter has proceeded. The infection may be supposed to 
have takeiyeifect, and to have produced the actual disease, when the 
person who has been exposed to its influence is attacked with giddi- 
ness, pain of the head, irregular heat and chills, nausea, and, if the 
infectious disease be small pox, convulsions. These symptoms are 
sutficient to denote the necessity for immediate medical advice. 

Temperature. — Next to ventilation nothing is of more importance 
than the regulation of the temperature of the sick-room, avoiding both 
extremes of elevation or of depression ; but much depends on the 
nature of the disease. 

The best general temperature of a sick-room is 60° (Fahr.) ; and it 
is preferable to regulate this rather by the thermometer than by the 
sensations of the patient or the attendants. Under some circumstan- 
ces, however, the feelings of the patient, and his susceptibility of 
impressions upon the skin, should not be overlooked. Thus if the 
temperature be a little above that of summer, and the patient, never- 
theless, feel chilly, it should be raised five or six degrees. This chil- 
liness is very apt to be felt in a dyspeptic state of the habit, and more 
especially when it is accompanied with hypochondriasis. It differs 
from that more severe but transient coldness which accompanies inter- 
mittent fevers, and some other periodical affections ; and it requires 
an elevated temperature of the air for its removal, whilst the cold 
stage of intermittent diseases is best relieved by the warm bath, 
either general or local. 

So important is the regulation of temperature, especially in fevers, 
that it often does more good than any other remedial measure. I 
have seen patients laboring under high delirium in a close, ill-venti- 
lated room, become rapidly quite collected by merely lowering the 
heat of the apartment twelve or fifteen degrees. 

In convalescence, as the air of the sick-chamber should be fre- 
quently renewed, the temperatue in spring and autumn ought to be 
maintained as near as possible at ^5i° to 60° Fahr. ; and it should be 
very gradually lowered as the invalid acquires strength, so as to ena- 
ble him to bear with impunity the varying temperature of these sea- 
sons in the open air. Even then, if the previous disease has been 
pulmonary, the air admitted to the lungs should be tempered by the 
use of the Respirator, or a muslin handkerchief tied around the mouth. 
When the invalid first ventures out of doors, nothing, indeed, is so 
essentia], in a prophylactic point of view, as avoiding extremes and 
sudden transitions of temperature. 

Cleanliness. — Although cleanliness in the sick-room is essential, 
yet it may be carried so far as to become an annoyance to the inva- 
lid, and consequently to prove injurious. It is not requisite to sweep 
the room daily, nor to dust and arrange the furniture every morning, 
provided order be preserved in the room, and nothing but what is im- 
mediately necessary for the comfort and convenience of the invalid 
be permitted to remain in it. It is truly distressing to observe the 
confusion which prevails in some sick-rooms ; everything being out 
of place, and to be searched for when it is wanted. 

70 



554 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

The period chosen for cleaning and arranging the sick-room should 
be the morning ; as, after a night's rest, the patient is more able to 
bear the little noise and bustle which it always more or less occasions. 
The carpet should be sprinkled with moist tea-leaves, and lightly 
swept ; and during this operation the curtains of the bed, if there be 
any, should be drawn. 

It is scarcely requisite to insist on the necessity of the utmost 
attention to the cleanliness of everything in the sick-room. The 
moment after any vessel or implement is used by the invalid, it should 
be removed from the apartment, and returned as soon as it is cleaned. 
Nothing in the form of a slop-basin or a slop-pail is admissible : they 
only administer to the laziness of nurses. 

The necessity of cleanliness in the vessels used for the food of in- 
valids is strikingly illustrated in the bad effects arising from the neg- 
lect of it when an infant is brought up by hand. In such a case, if 
either the feeding-bottle, or the boat, which is employed, be not in- 
stantly cleansed after the meal has been given, the small portion of 
the pap or food which remains in the vessel becomes sour, and taints 
the whole of the fresh food mixed with it, causing colic and convul- 
sions in the infant. The same risk of injury occurs in the sick-room, 
if the vessels used for administering food to the invalid be not in- 
stantly and well cleansed after every time they are used. 

It is too common also to use one glass or cup for administering 
medicines, and to leave it unrinsed from time to time, — a custom 
which may prove as deleterious as a defect of cleanliness in vessels em- 
ployed for food. Some medicines, when they are exposed to the air, 
rapidly undergo changes which alter their properties ; and this altera- 
tion having been undergone by the small portion which is always left 
in the glass or cup, communicates the disposition to be decomposed 
to that which may be next poured into the cup. An active medicine 
may be thus rendered inert ; or one which is mild in its operation 
may be so changed as to operate with hazardous energy. The same 
precaution, as to cleanliness, is also requisite as to the minim measure, 
when the medicines are directed to be administered in a form which 
requires its employment. 

Darkening the Sick-room. — It is a comn^on error to imagine that 
a sick-room should always be either partially or ivholly darkened. In 
some diseases, as, for example, fevers, when the eyes are acutely sen- 
sible to light, so that they remain half closed, and the eyebrows are 
contracted, the greatest relief is experienced from darkening the room. 
When delirium is present, a certain degree of darkening is in some 
instances serviceable ; whilst in others, especially when the delirium 
is accompanied with visual illusions, nothing so readily dispels these, 
and consequently abates the delirium, as the admission of the full 
daylight into the sick-room. There is much difficulty, however, in 
determining which state of the apartment is likely to be most ser- 
viceable in any particular case. Observation of the effects of light 
and darkness, in the individual case, must be our guide. 

These illusions of the sight are generally the result of former im- 



DO^IESTIC MANAGEMENT OF THE SICK-KOOM. 50O 

pressions, renewed at a moment when the brain is in such a disturbed 
condition as to set aside the exercise of judgment. In this condition 
of the brain, the renewed conceptions are not readily corrected, as in 
health, by impressions received from the external world ; hence, they 
become more vivid in the mind of the invalid when the sick-room is 
darkened, and all visible objects are shut out. They are usually dis- 
pelled by new impressions on the organ of sense chiefly implicated ; 
on which account, those which are connected with sight seldom occur 
during the day, when real objects are presentetl to the eye, unless the 
brain be so over-excited as to bring the conceptive faculty into intense 
exercise, sufficient to awaken those false perceptions which create a 
belief of the presence of individuals not only not present, but who 
have been long dead. This state of the mental organ is similar to 
that on which depends the spectral illusions of ,the insane, but differ- 
ing from it in its transient nature. I have frequently witnessed the 
conversation with one of these spectral beings instantly terminated, 
and the -whole illusion dispelled, on opening the window shutters of 
the room ; whilst the invalid has thus expressed himself: " Bless me ! 

I thought I was talking with Mr. , just now ; I must have been 

dreaming ; for now I recollect he has been dead many years." A 
twilight obscurity in the sick-room is often more productive of these 
illusions than darkness. 

The Nurse. — When all the arrangements are completed in the sick- 
room, little benefit can be anticipated if a proper nurse be not obtained 
to render them available to the invalid. Every female, who wishes to 
act as a sick-nurse, should be obliged to serve a certain time as an 
assistant nurse in one of the public hospitals, and to receive a certifi- 
cate of her efficiency before she leaves the establishment. The ad- 
vantages which the public would derive from a body of nurses edu- 
cated in this manner, must be obvious to every one who has had 
opportunities of observing the miserable working of the present 
system. 

In hiring a sick-nurse, the qualifications which should regulate our 
choice, refer to age^ strength^ healthy temper^ disposition^ habits^ and 
education, 

A^e. — She should not be under twenty-five, nor above fifty-five 
years of age. This period is fixed upon, on account both of the 
physical powers and the moral conduct of the individual. Under 
twenty-five, the strength of a woman has not reached its maturity, 
and is scarcely adequate for lifting patients in and out of bed, and 
for many other duties which require strength, connected with the 
office of a nurse ; but the strength and the muscular power in females 
begin to fail after fifty-five, when the natural transition from maturity 
to decay takes place. 

Strength. — The foregoing remarks respecting age render it al- 
most unnecessary to say that a woman of a naturally delicate 
frame of body is unfit for a sick-nurse : at the same time, a coarse, 
heavy, and masculine woman is, for many reasons, objectionable. 



0-36 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Whilst strength is requisite, the frame should be such as to indicate 
activity. 

Uealth. — None of the qualifications of a sick-nurse are of impor- 
tance more than health. An individual who herself requires attention 
is ill-calculated to attend upon others. A woman who is asthmatic, 
or has any difficulty of breathing, or an habitual cough ; who is rheu- 
matic or gouty, or has any spasmodic affection ; who is afflicted with 
palpitation ; or suffers from periodical headache, vertigo, or a tendency 
to paralysis ; or who is consumptive, or scrofulous ; or has defective 
sight or hearing ; or anything which causes decrepitude, is disquali- 
fied for a sick-nurse. It is important, also, to ascertain that there is 
no hypochondriacal nor hysterical tendency, nor predisposition to 
mental depression. 

Temper and Disposition. — It is scarcely requisite to say that an 
attendant upon the sick should possess a happy, cheerful, equal flow 
of spirits ; a temper not easily ruffled ; and kind and sympathetic 
feelings ; but, at the same time, not such as to interfere with firmness 
of character. The expression of the countenance should be open and 
winning, so as to attract the good-will and confidence of the invalid ; 
a pleasing and gentle manner being more likely to gain esteem, and 
insure obedience to the orders of the physician, than the most per- 
suasive arguments which can be addressed to the understanding of 
the patient. 

A collected, cheerful expression of the countenance, in the attend- 
ant on the sick, is likely to inspire hope, and to aid the efforts of the 
physician for the recovery of his patient. 

The general disposition of a sick-nurse should be obliging. Every 
little office which the invalid may require to be done, should be per- 
formed at once, and without the smallest apparent reluctance, even 
when the necessity for its immediate performance is not absolute. 
There is also an earnestness of manner, which should, if possible, be 
obtained or acquiesced in by the sick-nurse, as it impresses the idea 
that she feels deeply interested in the case ; a circumstance which is 
always highly appreciated by the patient. 

Finally, it is unnecessary to say that a nurse should be honest, as 
no description of servant has so much in her power. But the honesty 
of the nurse is not to be measured by her respect for property ; she 
must be above imposing on the physician, with respect either to medi- 
cines or to diet. Her religion, also, should be sincere, but not pharisai- 
cal ; and although she may occasionally persuade her charge " to put 
his trust in God, the fountain of health," * yet she must recollect that 
preaching is not her province ; and, when mistimed, even the best ad- 
vice may prove not only profitless, but injurious : and this is especially 
likely to be the result, when the doctrines which she professes are of a 
controversial kind. 

With respect to gossiping, it is a detestable habit under any circum- 

♦ Fuller. 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 557 

stances ; but, in a nurse, it may be productive of the greatest danger, 

produce family feuds, and a thousand other evils. 

• 

In her Habits, a sick-nurse should be sober, active, orderly, and 
clean, and neat in her person. 

The first of these habits — namely, sobriety^ — is so essential a 
qualification in every attendant in the sick-room, that it requires no 
comment. Happily, the desire for ardent spirits is now less frequent 
than formerly, when women were seldom employed as nurses until 
they were nearly superannuated, and until their habits, good or bad, 
were too firmly rooted to be removed. 

Tlie Activitj^ essential for a good nurse does not imply a bustling or 
fidgety manner, but a quiet, steady method of proceeding in the per- 
formance of her duties, equally devoid of fluster, turbulence, or noise. 
This activity is generally associated with orderly habits ; a most valua- 
ble qualification, and without which the sick-room becomes a scene of 
confusion and disgust. Every medical man must have witnessed this 
state of disorder with regret, when, on visiting his patient, he finds no 
chair to sit upon, until some article of bedding, or of clothing, be re- 
moved from it, and the seat dusted with the apron of the nurse ; and 
when a former prescription, or anything else, is wanted, he must wait 
until the nurse rummages out half a dozen of drawers in search of it. 

Another quality, usually conjoined with activity and orderly habits 
in a nurse, is cleanliness in her own person, and in that of her charge, 
as well as that of the sick-room. The dress of a nurse should be 
simple and neat, without trimmings. Nothing is more out of place 
than a fine lady attempting to perform the duties of a nurse. 

Education. — It may appear a refinement to talk of the education of 
a nurse ; but there is not a greater difference between noon-day and 
midnight than between an educated and an ignorant nurse. The for- 
mer is often an aid to the physician, not only in carrying his orders 
into effect, but by observing and informing him of symptoms of great 
importance which have occurred during his absence : whereas the lat- 
ter is a source of constant anxiety, and too often assumes the privi- 
lege of acting in direct contradiction to his orders, and according to 
her own opinion. 



Unhired Attendants. 

The selection of a good imrse, however eminently qualified she 
may be for her duties, does not supersede the attendance of a rela- 
tive or a friend in the sick-room ; on the contrary, I can conceive no 
condition so deplorable as that of an invalid left altogether to the care 
and management of a hireling. It is, nevertheless, too true that few 
ladies, even those who are wives and mothers, have any acquaintance 
with the arrangements of the sick-room, and the management of the 
invalid ; they are, consequently, too often forced to be guided by, and 
to rely for instruction on, the nurse, instead of being able to superin- 



558 do:mestic management of the sick-room. 

tend her conduct, to ascertain that she performs her duty, and to cor- 
rect her failings. 

•The degree of intelligence which is demanded in a nurse is very- 
different to that which is requisite for a wife or a relative in the sick- 
room. The intelligence of the nurse is directed to supply the wants 
of the invalid, to administer to his comforts, and to obey the instruc- 
tions of the physician ; that of the friend or relative involves the 
power of discriminating disposition and temper ; of watching the 
progress of the disease, and judging of the propriety of not pursuing 
certain measures, which, although indicated by the symptoms at the 
time of prescribing, yet may require to be altered, and consequently 
detailed to the physician, whose presence may be requisite before his 
next intended visit. It is of the utmost importance, also, that rela- 
tives attending in the sick-room should be able to control their feel- 
ings in the presence of the invalid. 

Nothing is more essential, in the domestic management of diseases, 
than a knowledge of the natural disposition and temper of the inva- 
lid. An irritable or a passionate man requires a very different man- 
agement from that which is proper for a man of naturally mild and 
easy disposition. Disease awakens in an augmented degree, the irri- 
tability of the former ; he becomes impatient of contradiction ; and 
every time his opinions are injudiciously opposed, the turbulent agi- 
tation of the nervous system which follows, either increases the dis- 
ease or weakens the influence of the remedial agents. On the other, 
hand, a mild and gentle disposition often leads to extreme sensitive- 
ness, when disease attacks the body : a word, a look, is sufficient to 
touch some sympathetic cord ; to unstring the whole nervous system ; 
and to augment the morbid susceptibility already present in the habit 
to a degree which is not always devoid of danger. Much discretion 
and judgment, therefore, are requisite in both instances : in the one 
case, to prevent ebullitions of temper ; in the other, to refrain from 
anything that might be construed by the invalid into harshness ; and 
yet, at the same time, in each case, to maintain that influence over 
the patient which the treatment of every disease demands in an at- 
tendant on the sick. 

Prejudice and Antipathies. — In those who are imperfectly or erro- 
neously educated, the judgment is apt to be biassed by prejudice and 
antipathies ; and, under the influence of these, it is misdirected in a 
manner of which the individual is often wholly unconscious ; thence 
the necessity of freedom from prejudice in the attendants in the sick- 
room, and the farther importance of the friends or relatives of the 
sick being able to superintend the conduct and the management of 
hired nurses. On the other hand, the judgment, even in the well-edu- 
cated, is apt to be misled by the affections^ the influence of which is 
as much opposed to the healthy exercise of discrimination as the pre- 
judices of the ignorant. Self-control, therefore, is also an essential 
qualification of the sick-room. 

It is only from knowing that the attendants of the sick are pos- 
sessed of intelligence and self-control, that a physician can rely upon 



DO:HESTIC MANAGEMENT OF THE SICK-ROOM. 559 

having his orders correctly and duly executed : when those qualities 
are absent, he has to dread, on the one hand, the presumption of igno- 
rant prejudice ; and, on the other, the improper yielding of sensitive 
indulgence. To the invalid, also, it is important to know that the 
directions of his physician are fulfilled by an intelligent person ; for, 
even in the most severe diseases, as long as the mental faculties re- 
main unaffected, a sick man is capable of detecting ignorance, or the 
effects of prejudice, in his attendants ; and, when he is convinced of 
the existence of either, all the influence of the individual, whether 
nurse, or friend, or relative, is at an end. 

Were the business of the sick-room (independent of the wants and 
comforts of the invalid) confined to the mere observation and collec- 
tion of facts — namely, the noting of the symptoms of disease — and 
reporting them to the physician, it would be superfluous to urge the 
necessity of superior intelligence in its superintendent ; but many of 
its duties require not only a well-regulated understanding, but an 
equally sound condition of the moral feelings and the benevolent af- 
fections,' with a recognition of the authority of conscience in the 
whole operations of life. In the period of sickness, under the direc- 
tion of the judicious and discreet, an invalid may be led to the inves- 
tigation of his moral and religious condition, and to review his past 
conduct, with the determination of turning the result to his future 
welfare, should he happily recover and re-enter society. Surely such 
important duties as these cannot be intrusted to the unqualified, or 
the ignorant, or the hireling ; nor can more be required to demonstrate 
the importance of adding to the other branches of female education 
a knowledge of the various important duties of the sick-room, which 
females, whether as mothers or daughters, or wives or friends, are 
likely to be called upon to fulfil. 

Prognostics. 

In every disease the medical attendant is naturally called upon to 
deliver his opinion of the degree of danger which hangs over the 
patient : hence, it unnecessary to enter into any minute details on the 
subject of prognostics. But, as in many diseases changes occur, in 
the absence of the practitioner, which ought instantly to be examined 
into, in order that the danger likely to accrue from them may be 
averted, it is important that the friends and ordinary attendants of 
the sick should be aware of their presence, so as to obtain the imme- 
diate assistance of the medical attendant. Were this information, 
also, more generally diffused, many unnecessary visits would be saved 
to the physician, and much unfounded suspicion of danger prevented 
from distressing and torturing the minds of the friends of the sick. 

In Fevers, delirium alone should excite no alarm, unless it be very 
high, or of the low, muttering, incoherent kind. In jaundice, and in 
diseases of the chest, it is alarming; and in the latter stages of 
pulmonary consumption, its presence always indicates the approach 
of death. 



560 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

Great confusion of thought^ loss of recollection of the most recent 
occurrence, a restless, wandering eye, and a correspondent vacancy or 
confusion of countenance, are always to be dreaded in fevers and in 
diseases of the brain. An expression of great anxiety is equally 
alarming in all acute diseases ; and a presentiment of death is still 
more to be dreaded. 

Hoarseness, with constant spitting, occurring at an early period in 
small-pox, is very unfavorable. 

Squinting in affections of the head ought to be particularly noticed, 
and mentioned to the attending practitioner ; and the same remark 
applies to a greatly contracted^ or a dilated^ or an immovable condition 
of the pupil of the eye ; or the turning up of the pupils under the 
upper eyelids. 

Deafness is not an unfavorable occurrence in continued fever ; but 
a sudden attack of headache in pulmonary diseases ought instantly 
to be mentioned to the physician. 

The Sudden Disappearance of Pain in inflammatory affections of 
the bowels is always to be dreaded ; but it does not in every instance 
portend the existence of mortification. 

Cough depending on inflammation of the bronchial membrane, 
suddenly supervening on a suppressed eruption, is always to be 
dreaded. 

In Croup, when the breathing is audible^ or when there is a crow- 
ing sound in inspiration, or a cooing or croaking respiration, danger is 
present. 

In Hooping'-Cough, when the paroxysms suddenly increase in vio- 
lence, and the face becomes livid, and the thumbs are drawn across 
into the palms of the hands, the appearance of convulsions may be 
anticipated : hence immediate notice of these symptoms should be 
communicated to the medical attendant. 

Rigors invariably excite alarm ; but they are only dangerous in 
chronic internal diseases, in which they often indicate the formation 
of pus, or the existence of suppuration. 

Pallidness of the countenance, with a slight degree of lividity^ are 
symptoms of hazard in the inflammation of the lungs. 

The Position of the Patient as he lies in bed, especially in fevers, 
is of much importance. Constantly lying on his back, with a ten- 
dency to sink to the bottom of the bed ; a propensity to keep the 
arms and the feet out of bed, and to uncover the trunk ; or to pick 
the bed-clothes ; tremors ; twitching of the tendons ; grinding of the 
teeth, and sleeping with the eyelids half open, and the white of the 
eyes only seen ; are all justly regarded as symptoms of great danger. 

Fainting (Syncope) is to be considered alarming in diseases of the 
heart, or during profuse bleeding from the nose, or from any other 



DO:^[ESTIC MANAGEMENT OF THE SICK-ROOM. 561 

part : deep sig-Iiing-, also, under such circumstances, is most unfavora- 
ble, and often indicates rapid dissolution. 

Ilieciip, in the advanced stages of either acute or chronic diseases, 
is invariably alarming. 

Difficiiltj' of Swallowing:, also, in the advanced stages of fever, palsy, 
and atfections of the head, always indicates extreme danger; vomiting'^ 
on the contrary, is not unfavorable, unless it be very severe and pro- 
tracted ; but, if the ejected matters be putrid, or feculent, then the 
vomit in or is alwavs to be dreaded. 

Coma, or an irresistible propensity to sleep, following the sudden 
suppression of gout, or the cessation of periodical bleeding in piles, 
or the healing of old sores, is always alarming, and requires prompt 
medical assistance. 

Convulsions without fever or any affection of the head, seldom 
prove dangerous : but they are never free from danger when they are 
accompanied with stupor or coma. They are also dangerous when 
inflammatory fever is present. They are less dangerous in women 
than in men, in the young than in advanced age. In infancy, convul- 
sions are more to be dreaded in the robust than in the delicate and 
irritable child. 

Diarrhoea is, under every circumstance, an unfavorable event, when 
it occurs either in fevers, or in the termination of chronic diseases ; 
and the passing of involuntary stools, when scarcely any diarrhoea 
exists, is equally to be dreaded. 

Retention of the Urine, as well as its involuntary discharge^ is al- 
ways an unfavorable symptom. 

Purple Spots appearing on the skin, livid lips and cheeks^ oozing of 
bloody sudden flushing's followed by pallor, are unfavorable symptoms; 
and the appearance of cedematous^swel lings of the legs and skin in 
the last stage of chronic organic diseases, always indicate approach- 
ing death. When purple spots, also, appear in small-pox, with flat- 
tening of the pustules on the trunk of the body, and a white pasty 
aspect of the eruption in the face; and if, at the same time, the 
extremities become cold, any hope of recovery can scarcely be enter- 
tained. 

Great and continued, or progressing emaciation in chronic diseases, 
and what is termed the fades Hippocratica, are to be dreaded. 

Excoriations on the parts on which the body rests, — for example, 
the haunches, or the lower part of the back, — especially if these be- 
come livid and sloughy, always indicate extreme danger. 

Great Difficulty of Breathing', even to a feeling of suffocation, is 
not necessarily hazardous in asthma; for although few diseases are 
so little under control by the interference of the physician, yet, 
asthma seldom proves fatal, unless it tends to the production of other 
diseases. 

71 • 



5G2 DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

In Coiisiuiiptioii, partial sweating, as of the head, the chest, or the 
limbs, are always unfavorable symptoms. 

When pregnancy occurs in a woman laboring under consumption, 
the disease is arrested, until after delivery, as if Providence threw a 
shield over the mother for the safety of the offspring. 

The Sudden Disappearance of Swelling of the Legs, in chronic or- 
ganic diseases, is indicative of approaching death. 

When a child, instead of rallying after any acute disease, becomes 
emaciated^ and the belly is large and tympanitic, there is always much 
danger. 

Ovarian Disease, or, as it is usually termed, ovarian dropsy^ has 
hitherto proved incurable ; but it is relieved by tapping ; and, if the 
powers of life be sustained by proper food, and carriage exercise in 
the open air ; and if all medicines be let alone, except such as are 
required to regulate the bowels, life may be sustained for many years. 

All diseases not involving organic changes, are, with a few excep- 
tions, more or less under the control of medicines, and are conse- 
quently curable. But some diseases, in which no organic changes 
have been discovered, are nevertheless incurable. This is the case 
with spasmodic asthma, which has rarely been cured. 

It is true that functional disturbances are not unfrequently associ- 
ated with organic diseases ; but, under such circumstances, it is the 
province of the attending physician to point out to the friends of the 
patient the greater or the less degree of danger in these complications. 

Diet, etc., in Disease and Convalescence. 

In numerous instances, much hazard often exists after disease has 
disappeared, and when the patient is declared convalescent : and as 
this period in the removal of diseases is left to the management either 
of the patient himself or of his friends, some general remarks respect- 
ing it, and also in reference to particular diseases, are requisite. 

In every recovery from sickness, whether external or internal, before 
the salutary advantages obtained from the treatment be confirmed, 
the organ or part which has suffered must be either left at rest or be 
used, according to the nature of the case. Thus, if any part have 
suffered from inflammation, it must not be used for some time after 
the inflammation is subdued. If the eyes have suffered, the person 
must neither read nor write, nor expose the eyes to the heat of the 
fire, nor to a strong light, until some days after every trace of the 
disease has disappeared. If the arm has been affected, it must be 
kept at rest ; and if the leg, riot only should walking be refrained 
from, but the limb should be placed rather higher than the trunk of 
the body. If the previous disease has affected the brain, every men- 
tal exertion must be avoided ; and so on, whatever may be the organ 
which has especially suffered. Even when the exercise of the organ 
is resumed, it should not be carried to fatigue, nor, on any account, 
should it be such as to produce excitement. At the same time, it 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 563 

must not be forgotten that, in the treatment of external injuries, when 
it has been necessary to keep the limb long in a sling, in one position, 
— as, for instance, in fractures, — the muscles which bend the arm 
acquire from the habit a contraction which cannot be overcome by 
the antagonist muscles, owing to the length of time they have been 
on the stretch weakening their contractile power. The arm, there- 
fore, should be frequently taken from the sling, and, being rested upon 
the elbow, a moderate weight should be held in the hand, and friction 
with oil employed upon the contracted muscles. It is true that sur- 
geons usually give directions for this operation, before they quit the 
management of the case ; but surgeons, as well as physicians, are 
sometimes dismissed before the convalescence is complete ; on which 
account, arms and limbs have remained contracted for life, from a want 
of the knowledge necessary to counteract the evil at an early stage. 

I say nothing respecting the continuance of remedies during con- 
valescence from many diseases, except urging the necessity of regu- 
lating the bowels. 

The most important part of the management of convalescence cer- 
tainly refers to air, exercise, and diet. The errors daily committed, 
in all of these matters, exert the most powerful influence in retarding 
complete restoration to health ; and often, indeed, induce evils of a 
more formidable kind than the diseases from which the patients have 
just emerged. 

1. Air. In every convalescence, whatever may have been the 
nature of the disease, if it has been so severe as to wear down the 
strength of the invalid, country air is essential. The benevolent 
Author of our existence has made medicinal the hills, the vales, the 
groves, and all the harmonies of nature ; and in the repose of these 
man finds a balm, not only for a wounded spirit, but for his stricken 
body. 

In selecting a country residence for a convalescent, care must be 
taken to ascertain whether any source of malaria exists in the neigh- 
borhood ; as, in that case, even if all other circumstances be favorable, 
the place is exceptionable. 

2. Exercise. In convalescence, much caution is requisite in appor- 
tioning the exercise to the degree of returning strength. When the 
convalescent is still too feeble to take sufficient exercise on foot, the 
best substitute for it is riding horseback ; but, as soon as walking can 
be borne, it should be preferred to either horse or carriage exercise. 

3. Diet. In health, diet may be left, in a great degree, to the in- 
clination or the taste, as far as regards the quality of the food ; and, 
although diseases occasionally originate from repletion, yet, in gen- 
eral, the appetite may be considered as the best regulator of quantity, 
when the food is simple, and the appetite is not pampered by high 
seasoning and rich sauces. In disease, however, a very opposite rule 
is to be observed : the regulation of both the quantity and the quality 
of the food is of the utmost importance. The taste is often so per- 
verted as to desire that which would prove injurious ; and were appe- 
tite to be the guide of quantity, diseases would frequently not only be 
increased in severity, but life itself would be brought into jeopardy. 



oCA DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

As soon as solid animal food can be taken with impunity, that 
which is most digestible should be selected. An opinion has gener- 
ally prevailed that gelatinous matters, and meats which readily yield 
jelly, — such, for example, as veal and lamb, — are the most easily 
digested, and at the same time, are also the most nutritive. This is 
a mistake ; for, with the exception of poultry, the flesh of young ani- 
mals is stringy and of a lax fibre, and is even less easily digested than 
that of too old animals, which presents a great density of texture. 
The middle-aged animals afford the most digestible food. 

Nothing tends to lessen the density of the fibre of every kind of 
animal food so much as keeping it for a certain time before it is 
cooked. In this case, the tenderness is the result of incipient decom- 
position or putrefaction ; but the utmost caution is requisite to pre- 
vent this from advancing so far as to present the slightest trace of 
taint, in the food of the convalescent. In the low state of vitality in 
convalescence, the change which commencing decomposition (putre- 
faction) causes, renders animal food, in that condition, a source likely 
to occasion either a relapse into the disease from which the patient 
has recovered, or to form a new disease. 

In examining the relative value of other articles of diet adapted for the 
sick and the convalescent, the first which presents itself to our notice is 

Milk. — As milk is the food of almost all young animals, its diges- 
tibility appears at once evident ; and there can be little doubt that it 
is very digestible, when it is drunk immediately after it is drawn from 
the udder of the cow, or that of the ass, or the goat, before its com- 
ponents have time to separate. When this separation is effected, 
either spontaneously by time, or by means of rennet or other agents, 
its properties are altered, and its digestibility is lessened. 

Cream, when intimately united with the other components of milk, 
— namely, the curd, or the caseous part, and the whey, — is not the 
same substance as after its separation. In the milk, it is more easily 
digested, and is the most nutritive part of the milk. But in its sepa- 
rate state, it is ill adapted either for the sick or convalescent, except 
in the form of butter, which is not unwholesome, unless it be eaten 
in excess or be melted.* In the same manner the separate curd is in- 
digestible ; and ivhe?/ itself, although highly nutritive, yet is flatulent ; 
nevertheless, it is an excellent demulcent in many cases of disease. 
But none of the components of milk are equal to milk itself. It is 
often necessary, in convalescence, to dilute it in water. 

Eo'g'S. — It is not uncommon to hear that the yolk of a raw egg, 
beaten up with water and sugar, with the addition of a small quan- 
tity of white wine, is a light and nutritive aliment in convalescence, 
and even in some states of disease : but eg-gs are much less digestible 
in this form than when they are lightly boiled. In jaundice, however, 
arising from viscid mucus obstructing the orifice of the common duct, 
the yolk of a raw egg beaten up with cold water is serviceable. 

* [Although cream is not as digestible as milk, yet it is much less liable to turn acid 
in the stomach ; it is often beneficial to dyspeptics, either alone or diluted Avith water.] 



DO:NtESTIC MAXAGEMENT OF THE SICK-ROOM. 565 

Fish, at least the white kind, stimulates much less than the flesh 
of land animals ; hence it is a proper food for those laboring under 
some acute diseases ; and also for convalescents, when a sudden re- 
turn to more stimulating food would prove hurtful. But it is not 
adapted for convalescents, when the object is to bring up rapidly the 
strength of debilitated habits. 

Raw oysters have been erroneously supposed to be both easy of 
digestion and nutritive. Thejatter opinion is, in some degree, true; 
but the former is erroneous. Raw oysters are less digestible than 
plainly cooked oysters. Both are improper for the sick and for early 
convalescents. Lobsters, crabs, prawns, cray-fish, scallops, and other 
shell fish, are still more objectionable. 

If fish of any kind be admissible, it should be simply boiled : fried 
fish is even worse for invalids than the outside or the brown of roasted 
meat. 

ye«:etables. — In reference to vegetable diet, it is only the mildest 
description of esculent roots that are fitted for the use of the sick. In 
preparing all of them for the sick-room, they should be well boiled in 
two distinct waters, until they are soft and very soluble, and in a state 
not to leave undissolved anything which could act as a mechanical 
irritant on the intestinal canal. When properly cooked, they are 
moderately nutritive, and free from any stimulant properties ; and 
they are well adapted for the stomach of the sick, unless in cases in 
which the torpor of the organ is such as to permit them to run into 
acetous fermentation and to prove flatulent. 

Fruits. — With respect to fruits, they produce the most de versified 
effects : and, consequently, are more or less proper for invalids, ac- 
cording to circumstances, either connected with themselves or with 
the condition of the patient at the time. The stone fruits, with the 
exception of the ripe peach, or the nectarine, are to be rejected. The 
apple tribe, except very soluble pears, are still less admissible. The 
apple, however, when roasted, and when the seeds and the hard cen- 
tral parts, as well as the skin, are removed, is less objectionable ; and, 
as it possesses laxative properties, the roasted apple is well adapted for 
the sick, when food is at all allowable, and when the bowels are tor- 
pid. The orange, if fully ripe, is grateful and wholesome to all inva- 
lids, and is only equalled in these qualities by the grape ; but in using 
the orange, the pulp should be rejected. Care, also, should be taken 
not to swallow either the skin or the seeds of the grape. Strawberries 
are a little stimulant, of easy digestion, and more cooling than the 
other small fruits; mulberries are, also, unexceptionable; but currants 
and gooseberries, and even raspberries, are not free from objection for 
invalids laboring under acute diseases. 

With the exception of oat and wheaten bread, all the varieties of 
farinaceous aliments may be regarded as modifications of starch, con- 
taining little nutritive matter, and therefore well adapted for the sick- 
room. It has been supposed that arrow-root, sago, tapioca, and simi- 
lar substances, are very nutritive, because they form mucilages with 
boiling water : but this is not the fact ; and were they very nutritive. 



UGG DO.AIESTIC MANAGEIVIENT OF THE SICK-KOOM. 

they would be ill adapted for invalids. Rice in every case where the 
stomach is in an acescent state, is preferable to the other farinaceae, 
because it is less fermentable. 

The farinaceous food, which is ordered in the convalescence of chil- 
dren from acute diseases, is often made of bread so as to constitute 
pap. No description of food has a greater tendency than this to be- 
come sour ; a quantity only sufficient for a single meal, therefore, 
should be made at a time ; for what remains is always sour before 
the next meal ; and even if the quantity be small, and it be mixed 
wdth fresh pap, it communicates its faculty of becoming sour to the 
whole mass. 

Fluid Aliments. 

M^ater, — The best and the most universal beverage for the sick is 
ivater : but the qualities of water differ, according to the sources 
whence it is procured. The fewer foreign ingredients it holds in 
solution the greater are its diluent properties. Distilled water, or rain 
or river water filtered, and that of soft water springs which filtrate 
through silicious strata, are the only kinds proper for the use of the 
sick-room. Hard water, under whatever name it is found, whether as 
spring water, or pump water, or well water, should be excluded. The 
impurities of river and rain water are merely held in suspension ; con- 
sequently, they are readily removed by filtration. 

Water itself is aliment ; many individuals under certain circum- 
stances have lived for a considerable time upon it alone. Those w^ho 
live chiefly on animal food require more drink than those who eat 
much vegetable matter. 

The influence of water on the animal economy may be regarded in 
two points of view : 

As an article of diet. 
As a medicinal agent. 

As an article of diet, in health, water is the beverage provided by 
nature for all animals, man not excepted. The sensation of thirst is 
the natural call for fluids, either to assist digestion, or to allay a dry, 
hot condition of the mouth and the gullet. The consequence of not 
satisfying this call is fever of a nervous kind ; and, if it be long re- 
sisted, inflammation of the air passages. On the other hand, too 
much fluid is injurious ; for although the vital powers of the stomach 
counteract the tendency which it affords, by over-diluting the gastric 
fluid, to the fermentation of the aliment in the stomach, yet, when it 
is in excess, those vital powers languish ; hence spontaneous chemical 
changes in the contents of the stomach take place, and induce dys- 
pepsia. For all the purposes of dilution, in health, water is adequate, 
and it is the only truly wholesome beverage. 

As a medicinal ag-ent, w^ater is demanded in every disease in w^hich 
a dry skin, and an elevation of the natural heat of the surface, consti- 
tuting fever, are present. In this case, the desire is for cold water, or 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 567 

cooling fluids ; and it should always be indulged. The degree of 
temperature, however, must be regulated by the condition of the in- 
valid : but the best medium temperature is between 50° and 60° Fahr.; 
although even 60° is too low, when the debility of the frame is consid- 
erable. 

The qualities of the various kinds of beverages proper, and gener- 
ally employed in the sick-room, should be known. 

Toast-water, when properly prepared, which it seldom is, forms a 
useful beverage in the sick-room. It is slightly nutritive, owing to its 
containing a small portion of gluten, in conjunction with fecula and 
sugar. It is one of the oldest and one of the best diluent demulcents ; 
diluting at the same time that it softens the acrimony of the secreted 
juices of the stomach, in febrile diseases. 

Gruel, whether made of groats or of oatmeal, is less mild and de- 
mulcent than barley water ; and it is more likely to undergo the ace- 
tous fermentation in the heat of the stomach ; a circumstance which 
is greatly favored by the sugar and butter which is sometimes added 
to it. Unless gruel be very thin, it can scarcely be regarded as dilu- 
ent; and when thick, it is too heating an aliment for patients laboring 
under febrile symptoms. 

Tea, in the form in which it is usually taken, is too stimulant and 
astringent to be a good diluent ; and, when it is strong, the narcotic 
property which it possesses renders it improper for most invalids, 
whatever may be the nature of their diseases. As it is, nevertheless, 
agreeable to most palates, and very refreshing, it may be taken in 
moderate quantity, provided it be not strong, without any hazard. 

Sage, balm^ and mint teas^ are often substituted for common tea. 
Each of them undoubtedly allays the irritability of the stomach in 
some cases ; but, as general beverages in disease, they are less useful 
than toast water. Raspberry vinegar, lemonade, tamarind tea, apple 
tea, and similar compound diluents, should never be administered 
without the consent of the physician. If a patient be taking an anti- 
monial, they will excite vomiting ; if a mercurial, griping ; and they 
are equally incompatible with many other medicines, and with many 
conditions of the stomach in disease. They are a description of 
beverage greatly recommended and largely distributed by the Lady 
Bountifuls in the country, and have frequently been productive of 
serious mischief. 

Coflfee is more heating, and, consequently, less admissible than tea ; 
it may, however, be taken, if it be largely combined with milk. Cocoa 
and chocolate are still more objectionable than either tea or coffee in 
the sick-room. 

With Respect to the Number of Meals, and the periods best adapted 
for taking them, it is scarcely requisite to remark, that, although in 
health, three moderate meals, at proper intervals, are customary, and 
well adapted for the support of the frame, yet, under the changed 



C>()>i DOMESTIC MANAGEMENT OF THE SICK-ROOM. 

condition of the system in disease, it would be improper to take any 
regular number of meals, or to observe any stated periods for taking 
them : hence no general rules can apply. 

As a general rule, in the decline of diseases, and on the approach 
of convalescence, when the desire of taking food returns, the best time 
for the principal meal, dinner, is about two hours after noon. If the 
breakfast be taken at nine o'clock, and the evening meal at seven, the 
hour of two is the middle period of the day ; so that, when dinner is 
taken at that time, the intervals between breakfast and dinner, and 
between dinner and supper, are not only equal, but neither is too 
short to limit the complete digestion of the previous meal; nor too 
long to injure the powers of the weakened stomach by protracted 
fasting. 

All acute diseases require more or less abstinence, especially when 
the object of the treatment is to lower the system ; and in some 
chronic affections, abstinence is almost essential. If this be true, the 
necessity of the strictest observance of the directions of the physician 
on this subject must be obvious. It is one, however, which is not 
only neglected, but is often combated both by nurses and friends ; 
and indulgences, which are supposed to be of too trivial a nature 
to cause any injury to the sick, have often been followed by fatal 
effects. 

But, although abstinence be requisite during the existence of an 
acute disease, yet it is injurious when it is too rigidly maintained 
after convalescence is actually established ; it often induces a new 
train of symptoms, not very unlike those for which it was properly 
prescribed, and the removal of which it has aided : namely, accel- 
eration of the pulse, increased impetus of the heart, headache, and 
even delirium. 

General Diseases. 

Happily, in febrile affections, the appetite of the invalid is not in 
a condition to desire food ; and no stronger demonstration can be 
required of the impropriety of forcing it upon him under such circum- 
stances. Simple fluids, such as diluents, are all that he desires, all 
that the stomach can bear; and such alone should be administered in 
fever, before that low condition of the system, which demands the 
use of wine or other stimulants, supervenes. In these cases, when 
the patient desires more nourishment than is usual, animal food ought 
not to be given, unless by the direct recommendation of the physi- 
cian. Indeed, in general, the inclination of the invalid happily re- 
volts from animal food, as much as experience condemns its adminis- 
tration. 

While febrile symptoms are present, farinaceous matters, little nu- 
tritious, such as barley-water, gruel, arrow-root mucilage, or sago, 
acidulated with lemon-juice, and sw^eetened to the taste of the patient, 
are most suitable ; but even these should be given in small quantity, 
and at considerable intervals. The beverage generally most agreeable, 
and also most salutary, to those suffering under fever, is cold water. 



DO^IESTIC MANAGEMENT OF THE SICK-ROOM. 569 

111 the decline of fevers even, as I have already remarked, although 
the severity respecting diet should be relaxed, yet much danger may 
result from mistaken kindness and over-zeal, in urging animal and 
stimulant food at too early a period of the convalescence. Indeed, 
the necessity of caution at this time is greater than during the con- 
tinuance of the fever ; and the more acute the disease has been, the 
greater must be the caution in the convalescence, especially if the 
treatment has been of an evacuant and lowering description. 

The first change of diet, in the decline of fevers, should be to an- 
other article of the same kind of food which was allowed in the dis- 
ease ; for example, from simple arroiv-root mucilage to arrow-root and 
milk, or to some other of the farinaceous compounds ; whilst, at the 
same time, asses^ milk may be given, in small quantity in the morn- 
ing. Rice, one of the farinaceae, is generally supposed to be astrin- 
gent, but this is a mistake. It forms an excellent diet in all cases of 
early but decided convalescence. It should be well boiled, and mixed 
either with broth and beef-tea, or gravy which has been cooled, and 
the fat taken from it. In the transition to animal food, beef-tea, 
chicken-broth, and mutton-broth, and other liquid animal decoctions, 
should be first resorted to ; then lohite-fish, simply cooked ; for, al- 
though fish is more digestible than animal food, yet it affords much 
less stimulant nourishment ; it is therefore better fitted for the early 
stage of convalescence. When convalescence is completed, a more 
generous diet is admissible. 

With respect to beverage, water, toast-water, or lemon-peel-vmter, is 
sufficient, until the medical attendant declares that a little wine is 
requisite. 

In convalescence from fever, it is an error to permit the patient to 
get up too soon. He should not leave his bed until his strength be 
considerably advanced. No danger can result from too strict an 
observance of this rule ; whereas much risk may be incurred by its 
neglect. 

If the head has been much affected, every mental exertion should 
be refrained from during the convalescence ; and, according to the 
degree of suffering in any local organ, precautions must be taken to 
guard that part of the frame against a fresh attack of disease. 

Eruptive Fevers require more precaution in convalescence than gen- 
eral fevers, both as regards diet and exposure to sudden alternations 
of heat and cold. This is more especially essential after measles and 
scarlet fever. 

Measles are often followed by a distressing cough, and other symp- 
toms of pulmonary inflammation ; or by a harassing diarrhoea, which 
wears down the strength ; or by inflamed eyes, catarrh, or obstinate 
toothache. In infants, canker of the mouth occasionally makes its 
attack and proves fatal. All these affections, after measles, might 
generally be prevented by taking care not to allow too soon a return 
to the use of animal food, or too early an exposure to cold or to night 
air. Even in summer, flannel should be worn next the skin for some 
weeks after the disease has disappeared. 

72 



570 DOMESTIC Mi^AGEMENT OF THE SICK-ROOM. 

Scarlatina is frequently followed by dropsical symptoms ; which, 
however, might generally be avoided by the same attention to diet 
and regimen as after measles. 

Small-Pox, when severe, and especially when confluent, is very apt 
to awaken into activity the dormant seeds of scrofula, if any heredi- 
tary taint exists in the constitution : hence abscesses, ulcers, and 
swelled glands, make their appearance. These demand the aid of 
the physician or the surgeon. But if the convalescent be properly 
dieted, and recourse be had to a change of air as soon as his strength 
will permit, these evils may be avoided. 

Erysipelas not unfrequently attacks convalescents from small-pox 
and other eruptive fevers. When it occurs, independent of any prior 
disease, the same attention to diet and regimen is requisite as in other 
eruptive fevers. 

Convulsions, it is well known, are not unfrequently the result of 
errors in diet, in individuals with an irritable condition of the stom- 
ach and bowels. Advice should always be demanded respecting the 
diet of those who are liable to, and w^ho suffer from, convulsions ; but 
it must not be supposed that, when they occur in children and have 
been subdued, a system of starvation is necessary to prevent their 
recurrence. As far as regards convalescence in such cases, it will be 
proper to bear in recollection the following rules : 

1. When the patient is of a full habit, has a short neck, and a ten- 
dency to diseases of the head, the diet should be spare. The use of 
animal food, indeed, in such a habit, should be wholly prohibited in 
childhood, and very sparingly employed by adults ; whilst vegetables, 
farinaceous matters, milk, and weak broths, may be allowed. 

2. When the habit of body is spare, and when languor and chilli- 
ness are present, the diet, although free from stimulus, yet should be 
nourishing, and consist of the lighter kinds of animal food ; namely, 
poultry and fish, with a moderate share of vegetable matters. 

3. Under all circumstances, and at every period of life, fermented 
liquors and wine should be either wholly avoided, or very sparingly 
used, in almost all convulsive diseases connected with affections of 
the head. 

In convalescence from some varieties of convulsive diseases, the 
nature of the diet must depend on circumstances which cannot be 
judged of by the attendants of the sick-room : hence it should be 
referred solely to the medical attendant. In St. Vitus' s Dance (chorea), 
for example, although a tonic plan of treatment may have been suc- 
cessfully pursued, yet the diet may be required to be mild, and w^holly 
free from stimulus. 

Attention to diet in Hysteria is most important. When the disease 
is connected with indigestion, the meals should be moderate ; and 
rest in the horizontal posture should be indulged for an hour after- 
wards, and then moderate exercise taken. Fluid food, such as broths 
and gruel, are improper ; yet animal food should be eaten only once 
a day. Tea and coffee should be very sparingly taken ; and the sim- 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 571 

plest beverages, even water and toast-water, should be taken in great 
moderation after a meal, and should not be drunk during dinner. 

In convalescence from hysteria, change of scene and air are abso- 
lutely requisite. The mind should be directed to solid studies, and 
everything which can cherish morbid sensibility of the nervous system 
avoided. 

Dropsy. — An opinion was long maintained that fluids are to be 
withheld from dropsical patients. No opinion was ever founded on 
more erroneous principles. Dropsical patients, indeed, should be al- 
lowed the free use of fluids. With respect to diet, it should, gener- 
ally speaking, be hght and unstimulating : but mucli depends on the 
causes of dropsy. There is, however, less necessity for a rigid ad- 
herence to low diet in this than in other inflammatory aflections. 

Ill Palsy, abstinence from all stimulating food, solid or fluid, must 
be rigidly observed; and the restriction should not be discontinued in 
convalescence. At the same time, change of air and of scene is al- 
ways of decided advantage. In every instance, an easy state of mind, 
and freedom from every source of irritation, as well as from the anxi- 
eties of business, are indispensable. 

Gout and Rheumatism. — In no diseases affecting the general habit 
are abstinence and repose more essential during the attacks than in 
the two which head this paragraph, when they assume an acute form. 
When they occur in weakened or in broken down habits, it is too 
often supposed that the opposite plan of diet is to be pursued, and 
that stimulating food and a liberal supply of wine should be indulged; 
but nothing is more likely to prove injurious. 

When the paroxysm subsides, it is too customary to permit the in- 
valid to glide into his usual habits with respect to diet and regimen ; 
consequently the plethora which originated the disease gradually re- 
turns ; and the same plan being continued, paroxysm follows after 
paroxysm, at shortening intervals, until scarcely any interval occurs ; 
and life is sacrificed on the altar of self-indulgence. 

For some weeks after the paroxysm of gout has subsided, in a 
young or a middle-aged man, animal food should be sparingly taken, 
and fermented liquors altogether avoided. 

Chlorosis, or Greeu Sickness, is a state of the habit which seems to 
depend on an impaired condition of the blood itself. Its treatment 
is well understood, and recourse to medical advice should never be 
neglected ; otherwise it may terminate either in mental derangement 
or in sudden death. In convalescence from it, the diet should be mild 
and light, but nutritious; the exercise should be much within the lim- 
its of fatigue, and consist of both walking and horse exercise, daily, 
in the open air : the body, more especially the lower extremities, 
should be warmly clothed : the mind ought to be amused ; all seden- 
tary occupations thrown aside ; and confidence placed in the honor 
of the physician, who should be made the repository of any mental 
anxiety, especially connected with the tender passion, which may be 
preying upon the vital energy of the body. 



0/2 DOMESTIC MANAGEMENT OF THE SICK-EOOM. 



Affections of the Head. • 

Whatever may be the cause of Apoplexy^ no disease requires more 
prompt and energetic treatment : the alarming nature of the symp- 
toms is always sufficient to prevent any time from being lost by at- 
tempts to relieve the sufferer without medical assistance. Should the 
attack not prove fatal at the time, and should it not be followed by 
palsy, still the utmost caution is requisite to prevent a recurrence of 
the disease. It is scarcely necessary to insist on the strictest adher- 
ence to temperance, both as to meat and to drink ; and the impor- 
tance of daily exercise, when the attack is over ; and indeed for the 
remainder of life. Prolonged study and intense thinking must be 
given up ; the violent and exciting passions should be subdued ; and 
even the pleasurable moderated. 

Inflammation of the brain is one of those diseases which require, as 
observed respecting Apoplexy, the most energetic treatment. When 
convalescence has fortunately been established, the attention of the 
physician is still requisite, during several weeks, until complete re- 
covery be fully confirmed ; for the brain, after suffering from inflam- 
mation, is very apt to relapse into the same state, from the excitement 
of too full a meal, or over-exercise, or even slight mental exertions or 
emotions. On this account, the convalescent must be kept perfectly 
quiet, and completely free from the smallest excitement ; and the 
strictest regimen observed. His diet should not only be mild and 
unstimulating, but small in quantity. 

Inflammation of the eyes requires the same caution when convales- 
cence is secured as other inflammatory affections ; namely, quiet, 
great moderation in diet, and avoiding exposure either to much light, 
heat, or cold, or whatever can stimulate the still highly excitable 
organ. 

Affections of the Chest. 

Inflammation of the Lnng'S (Pneumonia). — In convalescence from 
this disease, the temperature of the room in which the patient sits 
should not exceed 60° F. ; and it should be free from currents of air ; 
but, at the same time, it should not be close. The necessity for con- 
tinuing the same elevated position of the shoulders when in bed, 
which is demanded during the existence of the disease, remains even 
when the convalescence is advanced. The patient should be pre- 
vented from talking, and from exerting any muscular motion that can 
accelerate the circulation. The diet should be of that description 
which will support the strength without exciting or producing reple- 
tion. As the convalescence advances, and exercise is permitted by 
the medical attendant, it should be regular, but not hurried nor vio- 
lent ; and evening air should be sedulously avoided. 

Pleurisy. — Inflammation of the lining membrane of the chest re- 
quires the same attention to diet and regimen during convalescence 



DOMESTIC MxVNAGEMENT OF THE SICKROOM. 573 

a5> the last-mentioned disease, except that a greater strictness with 
regard to abstemiousness in food is requisite ; the least deviation 
being likely to bring on a rejiewal of the inflammation. When the 
disease assumes a chronic character, and when the object is to remove 
fluid effused into the cavity of the chest, and pressing upon the lungs 
so as to circumscribe their action, the same degree of strictness with 
respect to diet is not necessary; but, as in this condition of the habit 
the physician must continue his attendance, the regulation of the diet 
devolves upon him. 

Aii2;'iiia. — In that condition of the habit, which is connected with 
a predisposition to gout, but in which, instead of a regular paroxysm, 
the heart and the pulmonary organs become aftected, and the disease 
assumes that form which has been denominated diaphragmatic gout 
(Angina pectoris), the regulation of diet is of vital importance; and 
it should be of as low a standard as the constitutional powers will 
admit. It should not be of a description either to nourish much, or 
to augment or to cause fulness of habit: mild animal food, in mod- 
erate quantity, may be allowed ; but the staple should be of a farina- 
ceous kind; every stimulant, whether solid or fluid, should be avoided; 
and wine and malt liquors regarded as poisons. The invalid himself 
should be made aware, that whatever tends to excite or to hurry the 
circulation is calculated to bring on a paroxysm ; nor is it sufficient 
that he avoids all stimulating viands and beverages ; he should also 
be instructed that the same deleterious effects are likely to follow a 
full meal, even of the most proper and mildest food. 

The same attention to diet, both as regards quantity and quality is 
essential in palpitations depending on organic disease of the heart. 

Asthma. — In no affection of the chest is attention to diet so impor- 
tant as in asthma. Sir John Floyer, who himself suffered from the 
disease, recommends almost a degree of abstinence ; which is correct 
in reference to quantity ; but the diet, although of a light, yet should 
be of a solid, kind. This is especially necessary, when dyspepsia is 
present to aggravate and excite the disease of the lungs. 

Ill Hoopino'-cou^li, the diet, whether the patient be ,n adult or a 
child, should be of the mildest description ; and, perhaps, no nutri- 
ment is so well adapted to support the tone of the body, without 
exciting it, as milk. In infancy, nothing but the breast should be 
given ; the system of the nurse, at the same time, being kept as cool 
as possible by mild diet, and her mind in a tranquil state. If convul- 
sions occur, these sometimes depend on the nature of the milk ; in 
which case the nurse should be changed. It is still customary with 
non-professional persons to consider change of air essential in hooping- 
cough ; but it is only after the malady has run its course, and conva- 
lescence is progressing, when the cough remains as a habit, that 
change of air is really beneficial. It is unnecessary to combat the 
absurd opinion, that a change even to a worse air is salutary. 



])OMESTIC MANAGEMENT OF THE SICK-ROOM. 



Affections of the Stomach and Bowels. 

Although acute inflammation of the stomach rarely occurs, yet there 
is a chronic form of that disease, in which, during its actual existence, 
and also in convalescence from it, much of the safety of the invalid 
depends upon domestic management. Every source of excitement 
should be avoided ; the sick-room should be airy, and its temperature 
that of summer. The food should be of the blandest kind, given 
cold, or iced, and in small quantity ; even when the convalescence is 
established, the diet should consist of farinaceous matters, mixed with 
small quantities of beef-tea, or weak broths ; and this severe diet 
should be persisted in for a considerable time after recovery. 

Enteritis. — When inflammatory action extends to, or exclusively 
exists in, the mucous lining of the bowels, constituting this disease, 
the diet, during the early stage of it, should be confined to cold water, 
or iced almond-emulsion ; after which, milk and barley-water, or weak 
chicken or veal-tea, may be given in small quantities ; namely, two or 
three tablespoonfuls, at intervals of three or four hours. Nothing 
stronger should be ventured upon, unless expressly ordered by the 
medical attendant. 

Atonic Dyspepsia, or simple indigestion, — During the attack, absti- 
nence to a certain degree, is necessary ; but, if this is not essential, the 
diet should be somewhat stimulant, but simple ; namely, a small cup 
of moderately strong coflee, with little sugar or milk ; or beef-tea, 
with a small quantity of dry toast ; and, as the stomach begins to 
retain its tone, a little animal food of easy digestion, such as mutton 
or poultry. 

During the intervals of the paroxysms of indigestion, attention to 
diet is of the first importance. As a general rule, the patient should 
be confined to a spare animal diet, with a moderate share of well- 
hoiled vegetables, and a considerable restriction with respect to the 
use of fluids. 

Dysentery, which implies inflammation, acute or chronic, of the 
same membrane as in enteritis^ but confined to the larger and lower 
bowels, requires the diet to consist of the mildest farinaceous matters, 
strictly avoiding all solid animal food. It should be given in small 
quantity at a time, and the whole allowance for the day should be 
moderate. The farinaceous food should not be either solid, nor yet 
altogether fluid ; the former may prove injurious as a mechanical irri- 
tant ; the latter is apt to excite griping, from the extrication of much 
flatus. 

Diarrhoea. — Much of the domestic, as well as the medical manage- 
ment of diarrhoea depends on the nature of the attack, and its causes ; 
but too much attention cannot be paid to the regulation of the diet. 
It should be both small in quantity, and mild in quality. In the early 
stage, and the acute form of the disease, barley-water, arrow-root, 
made with water, rice or grit gruel, and light broths, are proper. In 



DOMESTIC MANAGEMENT OF THE SICK-ROOM. 575 

chronic diarrhcea, rice, properly boiled, and mixed with a small quan- 
tity of beef-tea, forms an excellent diet, as it nourishes moderately, 
and leaves scarcely any feculent matter behind it. 

lu Cholera, convalescence is often tedious ; and nothing is so likely 
to cause relapse as even slight irregularities of diet. For weeks after 
the feverish symptoms have disappeared, the diet should consist of a 
very moderate quantity of vegetable matter only. The feet should 
be kept especially warm, and the whole body clothed in flannel, to 
prevent that irregular distribution of blood which so strongly charac- 
terizes the disease. 

After inflammation of the lining membrane of the cavity of the 
belly {peritonitis) has been subdued, the invalid should still observe 
the strictest diet and regimen. He should return very gradually to 
the use of animal food and wine. The bowels should be moderately 
and daily opened, the feet kept warm, and the skin maintained in a 
healthy condition by wearing flannel next to it, for a very considerable 
time after every trace of the disease has disappeared. 

Diseases of the Liver. — In all cases of recovery from these diseases, 
whether inflammatory or otherwise, every precaution should be taken 
to guard against the deleterious influence of alternations of tempera- 
ture and also of damp, by clothing in flannel next the skin. Errors in 
diet should be avoided ; and fermented liquors and stimulating bever- 
age of every kind, refrained from. When pains of the side continue, 
after all the other symptoms of the disease have disappeared, the 
introduction of a seton, if prescribed, should not be objected to ; as 
the greatest benefit has often followed that mode of counter irritation. 



COOKERY FOR THE SICK-ROOM. 



It was said by the distinguished Dr. Rush, in his lectures before his 
class, that a physician ought to spend six months in a kitchen before 
beginning practice. A knowledge of dietetic preparations fitted for 
the sick, and for those recovering from disease, however apparently 
unimportant, adds much to a physician's power over his patient, and 
to his popularity and usefulness. 

In giving nourishment to the sick, who are suffering from low dis- 
eases, it is an important rule which should never be forgotten, to give 
hut little at a time, and to repeat that often. In cases of great prostra- 
tion from disease, life may at times be endangered by a delay in giv- 
ing nourishment of even a few minutes beyond the proper time. 

Barley-Water. 

Pearl barley, two ounces ; boiling water, two quarts. Boil to one 
half, and strain. A little lemon juice and sugar may be added, if 
desirable. To be taken freely in inflammatory diseases. 

Rice-Water. 

Rice, two ounces ; water, two quarts. Boil an hour and a half, 
and add sugar and nutmeg. 

Rice, when boiled for a considerable time, becomes a kind of jelly, 
and, mixed with milk, is a very excellent diet for children. It has in 
some measure a constipating property, which may be increased by 
boiling the milk. 

Decoction of Bran. 

Neav wheat bran, one pint ; water, three quarts. Boil down one 
third, strain off the liquor, and add sugar, honey, or molasses, accord- 
ing to the taste of the patient. A bran tea may be made by using 
boiling water, and suffering the mixture to stand in a covered vessel 
for three or four hours. 

Sage Tea. 

Dried leaves of sage, half an ounce ; boiling water, one quart. In- 
fuse for half an hour, and strain. Add sugar and lemon juice as 



COOKERY FOR THE SICK-ROOM. 577 

required by the patient. Balm and other teas are made in the same 
manner. 

The above infusions form agreeable and useful drinks in fevers, and 
their diaphoretic powers may be increased by adding a little sweet 
spirits of nitre. 

Barley Coffee. 

Roast one pint of common barley in the same way in which coffee 
is roasted. Add two large spoonfuls of this to a quart of boiling 
water ; boil five minutes. Add a little sugar. 

Lemon-Water. 

Put two slices of lemon, thinly pared, into a teapot, a little bit of the 
peel and a bit of sugar. Pour in a pint of boiling water, and cover it 
close two hours. 

A Refreshing Drink in Fevers. 

Put a little sage, two sprigs of balm, and a little sorrel into a stone 
jug, having first washed and dried them. Peel thin a small lemon, 
slice it, and put a small piece of the peel in ; then pour in three pints 
of boiling water. Sweeten, and cover it close. 

Another. 

Boil an ounce and a half of tamarinds, three ounces of cran- 
berries, and two ounces of stoned raisins, in three pints of water, till 
the water is reduced to two pints. Strain, and add a bit of lemon 
peel, which must be removed in an hour, as it gives a bitter taste if 
left too long. 

A Very Pleasant Drink. 

Put a teacupful of cranberries into a cup of water, and mash them. 
In the m^an time, boil two quarts of water with one large spoonful 
of corn or oat meal and a bit of lemon peel ; then add the cranberries. 
As much fine sugar as shall leave a smart flavor of the fruit, and a 
wineglassful of sherry. Boil the whole gently for fifteen minutes, 
and strain. 

Crust Coffee. 

Toast slowly one or two slices of brown or white bread, pour boil- 
ing water over it, and drink hot or cold, according to preference. 

Infusion of Malt. 

To one pint of ground malt add three pints of scalding water, that 
is, water not quite brought to the boiling point; infuse two hours, 

73 



578 COOKERY FOR THE SICK-ROOM. 

and strain. Add sugar or lemon juice as desired. An excellent pre- 
paration in inflammatory fevers. 

Lemonade. 

Fresh lemon juice, four ounces ; thin peel of lemon, half an ounce ; 
white sugar, four ounces ; boiling water, three pints. Let them stand 
until cold, and strain. When used in fevers, a little nitrate of potash 
or sweet spirits of nitre may be added. It may be further diluted to 
the taste of the patient. 

Water Gruel. 

Oat or corn meal, two tablespoonfuls ; water, one quart. Boil for 
ten or fifteen minutes, and strain, adding salt, and sugar if desired by 
the patient. 

Milk for Infants. 

Cows' milk, one part ; water, two parts ; sweeten slightly with loaf 
sugar. 

It is necessary when children are to be raised by hand to dilute the 
milk. The above proportions may be altered as the child advances 
in age. 

Rice Gruel. 

Ground rice, one heaping tablespoonful ; ground cinnamon, one 
teaspoonful; water, one quart. Boil gently for twenty minutes, add- 
ing the cinnamon near the conclusion. Strain and sweeten. Wine 
may be added in some cases. 

Panada. 

White bread, one ounce ; ground cinnamon, one teaspoonful ; 
water, one pint. Boil them until well mLxed, and add a little sugar 
and nutmeg. Wine or butter may also be added, if desirable. 

Compound Salep Powders. 

Salep, tragacanth, and sago, each four ounces ; cochineal, half a 
dram ; prepared oyster shells, one ounce. Mix, and divide into pow- 
ders of one dram each. Stir one of these powders into a pint of 
milk, and boil for ten or fifteen minutes. To be drunk freely in diar- 
rhoea and dysentery. 

Another. 

Gum arable, tragacanth, maranta, sago, tapioca, each two drams. 
Mix them well together, and boil in a pint of milk, flavored with nut- 
meg or cinnamon. To be used as a diet in dysentery, diarrhcea, etc. 



COOKERY FOR THE SICK-ROOM. 579 



Sago GrueL 

Sago, two tablespoonfuls ; water, one pint. Boil gently until it 
thickens, frequently stirring. Wine, sugar, and nutmeg, may be 
added, according to circumstances. 

Arrow-Root Gruel. 

Arrow-root, one tablespoonful ; sweet milk, half a pint ; boiling 
water, half a pint. To be sweetened with loaf sugar. Excellent ali- 
ment for children when the bowels are irritable. 



Tapioca Jelly. 

Tapioca, two tablespoonfuls ; water, one pint. Boil gently for an 
hour, or until it assumes a jelly-like appearance. Add sugar, wine, 
and nutmeg, with lemon juice to suit the taste of the patient, and the 
nature of the case. 

Jelly of Irish Moss. 

Irish moss, half an ounce ; fresh milk, a pint and a half. Boil 
down to a pint. Remove any sediment *by straining, and add the 
proper quantity of sugar and lemon juice, or peach water, to give it 
an agreeable flavor. 

Isinglass Jelly. 

Isinglass, one roll. Boil in one pint of water until it is dissolved. 
Strain, and add one pint of sweet milk. Put it again over the fire, 
and let it just boil up. Sweeten with loaf sugar, and grate nutmeg 
upon it. When properly made, it resembles custard. 

This forms an excellent diet for persons recovering from sickness, 
and is well adapted to the bowel complaints of children. 



Apple Water. 

Cut two large apples in slices, and pour a quart of boiling water 
on them. Or, pour the same amount of water on roasted apples. In 
two or three hours, strain and sweeten slightly. 

Milk Porridge. 

Wheat flour, corn meal, or oatmeal, two tablespoonfuls ; milk, one 
pint; water, one pint. Mix the flour or meal with cold water, to 
form a thin paste ; put the milk and water over the fire, and when 
they come to the boiling point, add the paste, carefully stirring. 



580 COOKERY FOR THE SICK-ROOM. 



French Milk Porridge. 

Stir some oatmeal and water together ; let the mixture stand to 
clear, and pour off the water. Then put more water to the meal, stir 
it well, and let it stand till the next day. Strain through a fine sieve, 
and boil the water, adding milk while so doing. The proportion of 
water must be small. With toast, this is a good preparation for 
weak persons. 

Ground-Rice Milk. 

Boil one spoonful of good rice, rubbed down smooth, with a pint 
and a half of milk, a little cinnamon, lemon peel, and nutmeg. 
Sweeten when nearly done. 

Boiled Flour. 

Tie up as tight as possible, in a linen cloth, one pound of flour ; 
and, after frequently dipping it in cold water, dredge the outside with 
flour till a crust is formed round it, which will prevent the water from 
soaking into it while boiling. Place it in water and boil until it be- 
comes a hard, dry mass. 

Two or three spoonfuls of this may be grated, and prepared in the 
same manner as arrow-root gruel, for which it is an excellent substi- 
tute. 

Vegetable Soup. 

Take one turnip, one potatoe, and one onion, let them be sliced 
and boiled in one quart of water for an hour. Add as much salt as 
is agreeable, and pour the whole upon a piece of dry toast. 

This forms an agreeable substitute for animal food, and may be 
given when the latter is inadmissible. 

Beef Tea. 

Lean beef, cut into shreds, one pound ; water, one quart. Boil for 
twenty minutes, taking off the scum as it rises. When it grows cold, 
strain. 

Essence of Beef. 

Lean beef sliced. Put a sufficient quantity into a porter bottle to 
fill up its body, cork it loosely^ and place it in a pot of cold water, 
attaching the neck, by means of a string, to the handle of the vessel. 
Boil this for an hour and a half or two hours ; then pour off the 
liquor and skim it. 

To this preparation may be added spices, salt, wine, brandy, etc., 
according to the taste of the patient, and nature of the disease. 



COOKERY FOR THE SICK-ROOM. 581 



Calf's-feet Jelly. 

Take t\^'-o calf's feet, and add to them one gallon of water. Boil 
down to one quart. Strain, and when cold, skim off the fat. Add 
to this the white of six or eight eggs well beaten, a pint of wine, half 
a pound of loaf sugar, and the juice of four lemons, and let them be 
well mixed. Boil the whole for a few minutes, stirring constantly, 
and then pass it through a flannel strainer. 

This forms a very nutritious article of diet for the sick, and for 
those recovering from disease. The wine may be omitted or added, 
according to choice. 

Chicken Water. 

Take half a chicken, divested of all fat, and break the bones ; add 
to this half a gallon of water, and boil for half an hour. Season 
with salt.' 

Suet Ptisan. 

Sheep's suet, two ounces; milk, one pint; starch, half an ounce. 
Boil slowly for half an hour. This may be used as a common drink 
in dysentery. 

Rennet Whey. 

New milk, one quart; rennet, a large spoonful. Heat the milk, and 
then add the rennet. Boil until the curd separates, which is to be 
taken off". To many persons, this forms an agreeable nutriment. 

Vinegar Whey. 

Milk, one pint ; vinegar, one tablespoonful. Boil for a few min- 
utes, and separate the curd. 

Tartar Whey. 

Milk, one quart ; cream of tartar, one dessert spoonful. Boil, and 
separate the curd. 

Mustard Whey. 

Bruised mustard-seed, one tablespoonful ; milk, one pint. Boil 
together for a few minutes, and separate the curd. 

This has been found a useful drink in dropsy. A teacupful may 
be taken at a time. 

Alum Whey. 

Alum, one teaspoonful ; milk, one pint. Boil together, and strain, 
to separate the curd. 



582 COOIi^ERY FOR THE SICK-ROOM. 



Orange Whey. 

Milk, one pint ; the juice of an orange with a portion of the peel. 
Boil the milk ; then put the orange to it, and let it stand till coagula- 
tion takes place. Strain. 

Sweet Whey. 

Skimmed milk, two quarts ; a piece of prepared calf's rennet. Mix, 
and put in a warm place till coagulation takes place ; then strain. 

Whey with Tamarinds. 

Milk, boiling, one pint ; tamarinds, two ounces. Boil them to- 
gether till coagulation takes place. 

Wine Whey. 

Milk, two thirds of a pint ; water, one third of a pint ; Madeira, 
or other wine, one gill ; sugar, one dessert spoonful. Place the milk 
and water together in a deep pan on the fire, and at the moment 
when it begins to boil, pour in the wine and the sugar, stirring assidu- 
ously whilst it boils, for twelve or fifteen minutes. Lastly, strain 
through a sieve. This is excellent in all forms of fever, given in 
small quantities. It maybe drunk either cold or tepid, a wineglassful 
at a time. 

Milk and Soda Water. 

Heat nearly to boiling, a teacupful of milk ; dissolve in it, a tea- 
spoonful of refined sugar ; put this into a large tumbler, and fill with 
soda water. This is an excellent mode of taking milk w^hen the 
stomach is charged with acid, and is oppressed by milk alone. 

Sippets. 

On an extremely hot plate, put two or three slices of bread, and 
pour over them some of the juices of boiled beef, mutton, or veal, if 
there be no butter in the dish. Sprinkle over them a little salt. 

Restorative. 

Take two calf's feet, one quart of water, and one quart of new 
milk ; place all in a close-covered jar, and bake three hours and a 
half. When cold, remove the fat. Any desired flavor may be given, 
by adding lemon-peel, cinnamon, or mace, while baking. Add sugar 
afterwards. 



COOKERY FOR THE SICK-ROOM. 583 



Coffee Milk. 

Boil a dessertspoonful of ground coffee in nearly a pint of milk, for 
a quarter of an hour, then put into it a shaving of isinglass, and clear 
it. Let it boil a few minutes, and set it beside the fire to clarify. 
Sweeten with loaf sugar. 

Nutritive Fluid. 

Take two teaspoonfuls of lump magnesia, one teaspoonful of sal- 
eratus, one teaspoonful of salt, two teaspoonfuls of flour, half a pint 
of milk, and one pint of water. Put the milk and water united over 
the fire, and rub up the flour with a little cold water to make a thin 
paste. Just when the milk and water begin to boil, stir in the paste. 
This will make a thin porridge, which should boil about five minutes. 
At the end of this time, remove from the fire, and pour into a pitcher. 
Now add the magnesia, pulverized, and mixed with the saleratus and 
salt. Sweeten to suit the taste. 

This may be drank freely, several times a day, so as to produce two 
evacuations of the bowels in twenty-four hours, in those cases of dys- 
pepsia attended by acidity of the stomach, and in many debilitated 
conditions of the system in which there is a tendency to loss of flesh. 

This is one of the leading fluids used by those who pursue what is 
called the " Nutritive System " of treating disease, and is really a val- 
uable preparation, having the effect often to increase the flesh, even 
while it acts as a cathartic. 



MEDICINES AND THEIR PREPARATIONS. 



Materia Medica. 



That department of medicine which treats of remedies, their doses, 
modes of using, and influences upon the constitution, is called materia 
medica. The agents employed in the treatment of disease are taken 
from three kingdoms of nature, — the vegetable, the animal, and the 
mineral. 

The largest portion of medicinal substances are taken from the 
vegetable world. They consist of leaves, flowers, seeds, barks, and 
roots. These lose much or all of their medicinal powers unless gath- 
ered at the right seasons of the year, and are properly cured. The 
different parts of a plant are to be gathered when their peculiar juices 
are most abundant in them. 

The Roots of Annnal Plants are best supplied with their juices be- 
fore they are in flower ; they should be gathered at this time. 

The Roots of Biennial Plants should be gathered in the autumn, 
after their first year's growth. 

The Roots of Perennial Plants should be gathered in the spring, 
before vegetation has begun. 

Before they are dried, the solid parts of these roots are to be cut in 
slices, after being washed, and the small fibres, unless they are the 
parts used, are to be thrown away. 

Bulbous Roots are to be gathered at the time their leaves decay. 
Their outer covering being rejected, they must be sliced, strung upon 
threads, and hung in a warm, airy room to dry. After being dried, 
roots should be packed in barrels or boxes, and kept as free as possi- 
ble from moisture. 

BiU'ks, whether of the roots, trunk, or branches, must be gathered 
in autumn, or early in the spring, when they peel off most easily, and 
the dead outside and all rotten parts being separated, they must be 
dried in the same manner as roots. The most active barks are gen- 
erally from young trees. 

Leaves are to be gathered when they are full grown, and just before 
the fading of the flower. 



^lEDICIXES AND THEIR PREPARATIONS. 



585 



Those of biennial plants are not to be collected until the second 
year. For drying, they should be thinly spread on the floor of a 
room through which a current of air passes. For preservation, they 
should be packed in vessels, and kept free from moisture, and insects. 

Flowers must generally be collected about the time of their open- 
ing, — either a little before, or just after. 

They should be dried as rapidly as possible, but not in the sun, and 
may be packed away in the same manner as leaves. 

Fruits, Berries, etc., may be spread thinly upon the floor, or hung 
up in bunches to dry. 



Articles to Accompany a Medicine Chest. 

As the author intends to prepare a Medicine Chest to accompany 
ithis volume, it is well to mention the following articles as necessary 
to be had with it : 

1. A Spatula for mixing ointments and pills, and for spreading 
plasters. 

2. A piece of smooth marble on which the above articles may be 
mixed, divided, and spread. 

3. A glass funnel. 
A domestic syringe for injections. 
Adhesive or sticking plaster. 
Lint. 



4. 

5. 
6. 

7. 
8. 
9. 



Scales and weights. 



A glass or wedgewood mortar and pestle. 

A graduated wineglass for measuring teaspoonfuls and table- 
spoonfuls of liquids. 

10. A minim graduated measure. 

11. A two-ounce graduated measure. 



O Dram. 



Fig. 186. 



Fig. 187. 



Minima. 







V) 








.55 
50 

45 
40 

S5 








25 
20 
15 


[■1 





3 Onnce, 




Dram. 



MINIM MEASURE. 



TWO-OUNCE MEASURE. 



The minim measure is represented by Fig. 186, and contains one 
fluid dram, or sixty minims, which is divided by twelve lines, — each 
line representing five minims. A minim is considered about equal to 
one and a half drops. 

74 



586 MEDICINES AND THEIR PREPARATIONS. 

The two ounce measure is represented by Fig. 187, and is divided 
off from half a dram upward. 

Doses, Weights, etc. 

Apothecary's weights, by which all medicinal preparations ought 
to be weighed, are divided into pounds, ounces, scruples, drams, and 
grains. 

The characters marked on weights and graduated measures, are 
explained as follows : 



§j one ounce, 
f §j one fluid ounce. 
§ss half an ounce. 
3j one dram. 



f3j one fluid dram. 
5ss half a dram. 
9J one scruple. 
9ss half a scruple. 



The grain weights are stamped with punch marks. 

20 grains make one scruple. I 60 drops make one fluid-dram. 

3 scruples make one dram. 8 drams make one fluid-ounce. 

8 drams make one ounce. • 16 ounces make one piSt. 

By apothecary's weight : 



ft The pound is equal to 12 ounces. 
§ " ounce " 8 drams. 

By apothecary's measure : 



5 The dram is equal to 3 scruples. 
9 " scruple " 20 grains. 



The pint is equal to sixteen ounces. 

3 " dram " ninety drops, or sixty minims. 

The marks and words used by physicians and apothecaries may be 
a little more fully explained by the following table : 

R stands for recipe, and means take, 

ad stand for ana, and mean of each. 

ft stands for libra vel lihrce, and means a pound or pounds. , 

§ stands for uncia vel unciae, and means an ounce or ounces. 

3 stands for drachma vel drachmce, and means a dram or drams. 

3 stands for scrupulus vel scrupuli, and means a scruple or scruples. 

O stands for octarius vel octarii, and means a pint or pints. 

f § stands for fluiduncia vel fluiduncice, and means a fluid ounce or fluid 
ounces. 

f 3 stands iov fluidrachma vel Jluidrachmce, and means a fluid drachm or fluid 
drachms. 

m stands for minimum vel minima, and means a minim or minims. 

Chart, stands for chartula vel chartulce, and means a small paper or papers. 

Coch. stands for cochlear vel cochlearia, and means a spoonful or spoonfuls. 

CoUyr. stands for coUyrium, and means an eye-water. 

Cong, stands for conguis vel conguii, and means a gallon or gallons. 

Decoct, stands for decoctum, and means a decoction. 

Ft. stands for Jiat, and means make. 



IMEDICINES AKD THEIR PREPARATIONS. 587 

Garg. stands for gargarysmOy and means a gargle. 

Gr. stands for graman vel grana, and means a grain or grains. 

Gtt. stands for gutta vel guttce, and means a drop or drops. 

Haust. stands for haitstus, and means a draught. 

Infiis. stands for infusum, and means an infusion, 

M. stands for misce, and means mix. 

Mass. stands for massa, and means a mass. 

Mist, stands for mistura, and means a mixture. 

Pil. stands for piiula vel pilulce^ and means a pill or pills. 

Pidv. stands for pulves velpulveres, and means a powder or powders. 

Q. S. stands for quantum sufficit, and means a sufficient quantity. 
S. stands for signa, and means WTite. 
Ss. stands for semis, and means a half. 

Domestic, or Approximate Measures. — A tablespoon contains about 
four drams ; a teaspoon, one dram ; a dessertspoon, three drams ; a 
wineglass, two ounces. Spoons vary so much in size, that they 
should no.t be used as measures in giving powerful medicines. 

The Approximate Value of French Decimal Weights. 

One centigramme is equal to \ grain. 

Two centigrammes " ^ grain. 

One demi-decigramme " 1 grain. 

One decigramme " 2 grains. 

One gramme " ' 18 grains. 

One gramme and three decigrammes is equal to 1 scruple. 
Two grammes " \ drachm. 

Four grammes " 1 drachm. 

One decagramme is equal to 2 drachms and 36 grains. 
Three decagrammes and two grammes is equal to 1 ounce. 
Demi-kilogramme " 1 pound. 

Kilogramme " 2 pounds. 

At Paris, the scruple is equal to 24 grains ; the drachm, to 72 
grains. 

Everywhere else, the scruple is equal to 20 grains ; and the drachm, 
to 60 grains. 

The following table shows the relative doses for young people of 
different ages : 

The dose for a person of middle age being 1 or 1 drachm. 

That of a person from 14 to 21 years will be f or 2 scruples. 

" " 7 to 14 " " 1 or ^ drachm. 

" " 4 to 7 " " i or 1 scruple. 

" of 4 " " ^ or 15 grains. 

" "3 " « 1 or 10 grains. 

" " 2 « « I or 8 grains. 

" « 1 " " -J^ or 5 grains. 

In administering medicines, it is always well to begin with the 
smallest dose mentioned and gradually increase until the desired in- 
fluence is produced. 



588 MEDICINES AND THEIR PREPARATIONS. 



Tinctures. 

The preparations called tinctures are made by grinding or bruising 
the roots, leaves, or barks used, to a coarse powder, placing it in the 
proper amount of either alcohol or diluted alcohol, letting it stand 
from seven to fourteen days, — shaking each day, — and, finally, filter- 
ing through paper. A large proportion of tinctures are made by tak- 
ing one ounce of the medicinal substance to one pint of the spirit ; and 
whenever tinctures are spoken of in this Materia Medica, and the 
quantities are not named, the above proportions are to be presumed. 
When a larger proportion of the medicine is to be used, I shall simply 
indicate the proportions in the fewest words, as under " Black Cohosh, 
— this tincture, four ounces to the pint of alcohol," meaning thereby, 
that the tincture is made by using four ounces of the root to the pint 
of alcohol. Tilden & Co.'s fluid extracts, which are the most reliable 
of any with which I am acquainted, have the same strength, ounce 
for ounce, with the roots, barks, leaves, etc., of which they are made. 
Tinctures may therefore be made with very little trouble, by substi- 
tuting, in each case, the same number of ounces of their fluid extracts 
to the pint of alcohol, which I name of the gross substance, or, when 
no quantity is named, one ounce to the pint. 

Infusions. 

Infusions are solutions of vegetable medicines, generally obtained 
by pouring boiling water upon the substance, and letting it stand till 
it cools. When a more prolonged application of heat is desired, the 
vessel may stand for a while by the fire, but must not be permitted to 
boil. The vessel should usually be covered. 

As in the case of tinctures, I have uniformly, while writing this 
Materia Medica, briefly named the quantity to be used to the pint, 
whenever it varies from one ounce. 

Acetic Acid. — This is a clear liquid, without color, and has a strong, 
sour taste, and an agreeable smell. When held to the nose, its fine, 
pungent odor often relieves headache. A piece of cambric wetted 
with it and applied to the skin, excites heat and redness, and, very 
soon, a blister, — for which this acid may be substituted in inflamma- 
tory sore throat, and other cases requiring speedy action. Applied to 
corns and warts, with a camel's-hair brush, it destroys them. One 
part to seven of water, makes a good vinegar. 

Citric Acid.. — This acid is extracted from lemon, or lime juice; it is 
also present in the cranberry, currant, strawberry, raspberry, tamarind, 
and is very abundant in the red elderberry. It is refrigerant, and anti- 
septic, and is chiefly employed as a substitute for lemonade. Nine 
and a half drams of the crystals, two drops of oil of lemon, and one 
pint of water, answers a good purpose, in place of lemon-juice. 

Diluted Nitric Acid. — This, in the undiluted state, passes under the 



MEDICINES AND THEIR PREPxVRATIONS. 589 

name of aqua-fortis. It is tonic and antiseptic. Largely diluted with 
water, it forms a good drink in fevers, especially typhus. Taken in 
large doses, it is a powerful poison. One dram of this preparation, 
thirteen ounces of soft water, and one ounce of simple syrup, make a 
good drink in fevers, of which half a wineglass to a wineglassful is a 
dose. Excellent in cases of hooping-cough. 

Xitro-Muriatic Acid, — This acid, when properly diluted, has a tonic 
and stimulant influence. It is much used as a foot-bath in affections 
of the liver, and in deficient secretions of the bile. 

Diluted Hydrochloric Acid, — This is known by the name of diluted 
muriatic acid. It is tonic, antiseptic, and diuretic, and is used in 
typhus, eruptions of the skin, and with other articles, as a gargle in 
inflammatory and putrid sore throats. Dose, from five to twenty 
drops, in a wineglassful of water. It is given in scarlet and typhoid 
fevers, about twenty drops being put into a bowl of barley-water or 
gruel. 

Diluted Hydrocyanic Acid, — This is commonly known by the name 
of prussic acid. It is sedative and antispasmodic, and is useful in 
spasmodic coughs, asthma, hooping cough, nervous affections, hic- 
cough, palpitation of the heart, irritable stomach, and dyspepsia. 
Dose, from two to five drops, in a glass of water or tea of Peruvian 
bark. 

Diluted Sulphuric Acid. — This acid, known by the name of diluted 
oil of vitriol, is tonic, antiseptic, refrigerant, and astringent. It is 
useful in dyspepsia, diabetes, menorrhagia, haemoptysis, eruptions of 
the skin, hectic, and diarrhoea. It is often given with some bitter in- 
fusions, as cascarilla, columbo, peruvian bark, or quassia. The aro- 
matic sulphuric acid is often used in place of it, being sometimes 
considered more grateful to the taste. Dose of each, from five to 
fifteen drops. 

Tannic Acid. — This is an astringent preparation, and passes under 
the name of tannin. It is prepared from galls. It is used in diar- 
rhoea, dysentery, passive hemorrhages, and diabetes. Dose of the 
powder, from one to five grains. 

Tartaric Acid, — This is refrigerant and antiseptic, and is used in 
inflammatory affections, fevers, and scurvy. It is much used in pre- 
paring what is called lemon syrup, and forms an agreeable and health- 
ful drink. 

Alcohol, — Alcohol is the result of the fermentation of the juices of 
many vegetables. It is the intoxicating constituent in whiskey, rum, 
brandy, gin, wines, porter, ale, beer, and cider. Its principal use in 
medicine is in the preparation of tinctures, essences, and extracts. 
One part of pure alcohol, to one part of water, forms the diluted alco- 
hol of the shops. 

Almonds. — The Amygdalus Communis^ or almond tree, grows in the 
south of Europe and Asia, and yields the sweet and bitter almond. 



590 MEDICINES AND THEIR PREPARATIONS. 

The oil of the sweet almond is used as a demulcent, in coughs, etc. 
A dose is a teaspoonful. The oil of the bitter almond is poisonous, 
and is occasionally used as a valuable sedative. Its taste is like that 
of a peach kernel. Dose, from a quarter of a drop to a drop. It 
owes its poisonous properties to hydrocyanic acid. Cakes, etc., are 
sometimes flavored with an essence prepared from it. 

Aloes. — This is the hardened juice of the leaves of several species 
of the aloe tree, in North and South Africa, in the south of Europe, 
and in the island of Socotra. Aloes is purgative, acting chiefly upon 
the rectum, or lower bowel, in which it frequently produces irritation, 
and is apt to aggravate and induce piles. It is much used to excite 
the flow of the menses, and should never be given to women during 
pregnancy. It produces griping of the bowels, which may be dimin- 
ished by combining it with soap, or carbonate of potash. 

Alum [Alumen). — The chemical name of this is sulphate of alu- 
mina and potassa. In ordinary doses, alum is astringent and anti- 
spasmodic. In large doses it is purgative and emetic, and is used 
both externally and internally. It is often used in solution as a gar- 
gle in sore throat, and falling down of the uvula, and as an injection 
in leucorrhoea. In doses of thirty or forty grains, it acts as a purga- 
tive, and used in this way, is useful in painter's colic. When exposed 
to heat in a vessel till it ceases to boil, it becomes dry, and is then 
called burnt alum, which, when pulverized, is applied with advantage 
to canker spots in the mouth, and to proud flesh. 

American Hellebore (Veratrum Viride). — This plant grows in many 
parts of the United States, usually in swamps, wet meadows, and on 
the banks of mountain streamlets. The root is the part used. It is 
slightly acrid, alterative in a marked degree, very decidedly and ac- 
tively expectorant and diaphoretic, and it is an excellent nervine, 
though not narcotic. But its most marked and valuable quality — 
that in w^hich it has no rival — is its sedative action upon the circula- 
tion. In suitable doses, it can be relied upon to bring the pulse down 
from a hundred and fifty beats in a minute to forty, or even to thirty. 
In fevers, therefore, in some diseases of the heart, in acute rheuma- 
tism, and in many other conditions which involve an excited state of 
the circulation, it is an article of exceedingly great value, because it is 
always reliable. It has recently come into use ; and I doubt whether 
so valua*ble a contribution has been made to our list of medicines in 
a hundred years. 

Preparations. — Veratrum is used chiefly in the form of tincture, 
six ounces to the pint of diluted alcohol, or of fluid extract. The 
dose of each of these preparations, for a grown person, is three or 
four drops, every hour or two, in a little sweetened water, and gradu- 
ally increased, if necessary, till the pulse comes down to sixty or 
seventy. If taken in so large a dose as to produce vomiting, or too 
much depression, a full dose of morphine or laudanum, in a little 
brandy or ginger, is a complete antidote. 

Veratrin, the active principle of veratrum, is also used, in doses of 
one-half to one-third of a grain. 



MEDICINES AKD THEIR PREPARATIONS. 591 

American Ipecacuanha (Euphorbia Ipecac). — This plant is peren- 
nial, and grows in sandy soils in the Middle and Southern States. 
When cut or broken it gives out a milky juice. The root is the 
medicinal part. It is emetic, cathartic, and diaphoretic. Dose, as a 
cathartic, ten or twelve grains ; as a diaphoretic, three or four grains, 
every three or four hours. 

American Ivy {Ampelopsis Qidnquefolia). — This vine grows in all 
parts of the United States. It is known by the names of false grape, 
and ivild icoodbine. It is alterative, tonic, astringent, and expecto- 
rant. Used in scrofula and syphilis. 

Water of Ammonia [Liquor Ammonice). — This preparation, called 
hartshorn, or spirits of hartshorn, is formed by the union of water 
with ammonia gas. It has a powerful ammoniacal odor, and an 
alkaline, caustic taste. Taken internally it is stimulant, sudorific, and 
antacid, and applied externally, it is rubefacient. It stimulates par- 
ticularly. the heart and arteries, without very much exciting the brain. 
It is an excellent remedy in heartburn, and for sick headache, depend- 
ent on sourness of the stomach. A dose is from ten to thirty drops, 
largely diluted with water. United with oils, or with alcohol in about 
equal proportions, and applied externally, it reddens the skin, and, if 
the cloth wet with it be covered with oiled silk, or with flannel to pre- 
vent evaporation, it will sometimes quickly raise a blister. In cases 
of fainting, it is frequently applied to the nostrils, to excite the brain, 
and rouse the system. 

Carbonate of Ammonia. — This is a white, moderately hard, crys- 
talline salt, — having a pungent, ammoniacal smell, and a sharp, pen- 
etrating taste. When exposed to the air, it loses some of its ammo- 
nia, becomes a bicarbonate, and falls to powder. It is stimulant, 
diaphoretic, antispasmodic, powerfully antacid, and, in large doses, 
emetic. Internally, it is more often used than water of ammonia, 
and for similar purposes. Coarsely bruised, and scented with oil of 
lavender, it constitutes the common smelling salts, so much used in 
fainting and hysterics. For internal use, the dose is from five to 
twenty grains, taken in the form of pills, every two, three, or four 
hours. 

Muriate of Ammonia (Sal Ammoniac). — This, also called hydro- 
chlorate of ammonia, is a white, translucent, tough, fibrous salt, in 
large cakes, about two inches thick, convex on one side, and concave 
on the other. 

It has a saline, pungent taste, but no smell, dissolves in one part 
of boiling water, and three parts of cold. Taken internally, it is 
stimulant and alterative. It is a valuable remedy in chronic bron- 
chitis, pleurisy, and inflammation of the serous and mucous mem- 
branes generally. But it must only be used after the first violence of 
these inflammations has abated. Pulverized, and placed over a spirit 
lamp in a tin cup, the fumes which arise when it sublimes, may be 
inhaled five or ten minutes once or twice a day, with great advantage 
in chronic bronchitis, and in chronic inflammations generally of the 



592 MEDICINES AND THEIR PREPARATIONS. 

air passages. A solution composed of one ounce of the salt dissolved 
in nine fluid ounces of water, and one of alcohol, may be used as a 
wash, for bruises, indolent tumors, and ulcers. 

Solution of Acetate of Ammonia (Liquor AmmonicB Acetatis). — This 
is known by the common name of spirit of mindererus. The taste 
is saline, and is like that of a mixture of nitre and sugar. It is a 
valuable diaphoretic, and is much employed, alone or mixed with 
sweet spirit of nitre, two parts to one, in fevers and inflammations. 
It is a valuable external application in mumps, applied hot upon a 
piece of flannel. One ounce mixed with seven ounces of rose-water, 
and two drams of laudanum, forms a valuable wash for the eyes in 
chronic ophthalmia. The dose is from two drams to half a fluid 
ounce, mixed with sweetened water, every two or three hours. 

Aromatic Spirit of Ammonia (Spiritus Ammonice Aromaticus). — 
Taken internally, this answers the same purpose of other prepara- 
tions of ammonia, and is much used on account of its agreeable 
taste and smell. It is valuable as an antacid in sick headache. 
Dose, from thirty drops to a dram, sufl[iciently diluted with water. 

Anise [Pimpinella Anisum). — This is a perennial plant, and grows 
in Egypt. Its fruit is called anise-seed. It is aromatic and carmina- 
tive. It is much used to allay nausea, flatulency, and colic, particu- 
larly in children. It is frequently added to other medicines to make 
them more agreeable, and to lessen the griping effects of physic. 

The oil extracted from the seeds, dissolved in alcohol, an ounce of 
the former to a pint of the latter, forms what is called the essence of 
anise. Dose of the essence, from thirty drops to a dram in sweetened 
water. Anise forms a very valuable addition to cough preparations. 

Arnica (Arnica Montana). — This is a perennial plant, growing in 
moist, shady places in Siberia, etc. It is often called leopard's bane. 
It is much used externally as a stimulating application to bruises, 
local inflammation, etc. 

Preparations, — It is chiefly used in the form of tincture, or fluid 
extract. Dose, ten to sixty drops. Half an ounce of tincture, five 
and a half ounces of boiling vinegar, and two drams of carbonate of 
ammonia, used warm, make in some cases a valuable fomentation. 
It is one of the leading homoeopathic remedies. 

Arrow-root. — This is prepared from the Maranta Arundinacea, a 
plant of the West Indies. It is chiefly used in forming dietetic pre- 
parations, and belongs to the first or saccharine group of food-articles 
(see page 66). 

Assafoetida. — This is the hardened juice from the root of a Persian 
plant. It is stimulant, antispasmodic, and expectorant, and is much 
used in nervous complaints. A dose of the powder, is from five to 
ten grains, and of the tincture, made by macerating two ounces in a 
pint of diluted alcohol, from thirty to sixty drops. 

Balm (Melissa Officinalis). — This is a perennial plant, growing in 
Europe and this country. It is moderately stimulant and diaphoretic. 



MEDICINES AND THEIR PREPARATIONS. 593 

The warm infusion causes perspiration, and is used to relieve painful 
menstruation. 

Babii of G Head [Popidus Candicans). — This is a tree growing in 
the northern parts of our country. A tincture made from the buds, in 
doses of from one to four fluid drams, is useful in aifections of the 
kidneys, in scurvy, and rheumatism. Steeped in lard they form a use- 
ful ointment for some purposes. 

Biilinoiir (C/ielone Glabra). — This is a perennial plant, common to 
the United States. It is tonic, cathartic, and vermifuge. It is used 
in indigestion, debility, and derangements of the liver. A dose of the 
powdered leaves, is one dram ; of the tincture, two fluid drams ; of 
the decoction, one or two fluid ounces ; of the active principle called 
chelonin, one to two grains. A decoction of balmony combined with 
tincture of assafoetida, forms a valuable injection for worms. An 
ointment made from the fresh leaves, is valuable for piles, inflamed 
breasts, tumors, and painful ulcers. 

Balsam Copaiva. — This is obtained from a South American tree 
called the Copaifera Officinalis. It is a clear yellowish flnid, about 
the consistence of honey. It is a stimulating diuretic, and is much 
used in chronic gonorrhoea, gleet, irritable conditions of the bladder, 
and chronic bronchitis. In some persons it causes an eruption on the 
skin, with itching, etc. 

In large doses, it acts as a cathartic. 

Balsam Tolu. — This is the juice of the tree Myrospernum Tolui- 
ferum, growing in South America. It is soft, tenacious, and of a 
pale brown color ; and, like balsam copaiva, is soluble in alcohol, 
ether, and volatile oils. It has been used in asthma, cough, bronchitis, 
etc. Dose from ten to thirty grains, in mucilage or syrup. 

Barberry (Berheris Vulgaris). — This shrub grows along the Atlan- 
tic coast, from Canada to Virginia. The parts used are the bark and 
berries. It is tonic and laxative, and, in doses of a teaspoonful, pow- 
dered, is useful in jaundice, chronic diarrhoea, and chronic dysentery. 
A decoction of the berries forms an agreeable acid drink in fevers, 
cholera infantum, etc., and as a gargle, it is useful for ulcers of the 
mouth, etc., as a wash, for chronic inflammation of the eyes, and as an 
injection for leucorrhoea. 

Bear-berry (Uvaursi). — This plant, also called upland cranberry, 
has a wide range, being found in the northern parts of Asia, Europe, 
and America. It flowers from June to September, and ripens its 
berries in the winter. The leaves are the only medicinal parts. It is 
astringent and tonic, and acts particularly upon the urinary organs, 
for complaints of which it is particularly used. It is specially valued 
as an antiMthic in gravel, and as a remedy for chronic inflammation 
of the kidneys, and ulceration of the bladder, etc. 

Preparations. — Fluid extract, dose, one third of a dram to a dram ; 
solid extract, dose, five to fifteen grains ; tincture, dose, one to two 
ounces. 

75 



594 



Mr.DICIXES AND THEIR PREPARATIONS. 



BaybeiTV (Mijrica Cerifera). — This is found in damp places, in 
many parts of tlie United States, and is very abundant in New Jersey. 
The bark of the root is the part used. It is astringent and stimulant. 
Pulverized, and combined with powdered blood-root, it forms an ex- 
cellent application to indolent ulcers. In the form of poultice, com- 
bined with powdered slipjK'ry elm, it is a useful application to scrofu- 
lous tumors or ulcers. The decoction is a good wash for sore mouth, 
and spongy, bleeding gums. It is chiefly used in the form of tincture, 
dose, half an ounce ; fluid extract, dose, one to two drams ; and the 
active principle myricin, dose, two to ten grains. 



Fig. 189. 



Fig. 188. 







BEAR-BERRY. 



BAYBERRY. 



Beef's Galls {Fel Bovinum). — This being dried by evaporation, is 
sometimes used as a tonic, and laxative, in torpor of the liver, jaun- 
dice, indigestion, 'And costiveness, in doses of from one to ten grains. 
Three drams of ox gall, one dram of extract of conium, two drams 
of soda soap, and one ounce of sweet oil, make a valuable prepara- 
tion, which, when applied externally, has a surprisingly rapid effect in 
reducing enlargement and hardening of the breasts, glandular tumors, 
particularly enlargement of the tonsils, and is useful in hypertrophies 
generally. For application to the tonsils, the gall may be rubbed up 
with water, to the consistence of an ointment, and may be applied 
with a camel's-hair brush. 

Benzoin. — This is the hardened juice of a tree of Sumatra and 
Borneo. It is very brittle, of a reddish brown color, and is soluble in 
alcohol and ether. It is chiefly used for inhalation in chronic laryn- 
gitis and bronchitis. When used for this purpose, it may be added to 
boiling water, and the vapor be inhaled ; or it may be burned upon 
coals, or a hot shovel, the fumes being inhaled. 

Benzoic Acid. — This is prepared by heating benzoin, and causing 
it to sublime. It consists of silky, feathery crystals, which are white 
and soft. It has been found useful in the phosphatic variety of gravel. 
A convenient way of giving it is to unite one part of it with four parts 
of phosphate of soda, the dose of which is from ten to thirty grains. 



MEDICINES AND THEIR PREPARATIONS. 



]do 



Bethroot {TrWium Penduhim). — A perennial plant, growing in rich 
soils, in the ^liddle and Western Stales. The root is used, and is 
astringent, tonic, and antiseptic. It is useful in bleeding from the 
lungs and kidneys ; also in excessive menstruation, cough, asthma, 
and difficult breathing. Boiled in milk, it is used, in the western 
country, in diarrhoea and dysentery. 

Preparations. — Fluid extract, dose, one to three drams; trilliin, 
dose foar to eight grains ; infusion, dose, two to four ounces ; decoc- 
tion, used as a local application to ulcers and sore mouth, and as an 
injection in leucorrhoea and gleet. A poultice made from the root, is 
useful for carbuncles, indolent tumors, buboes, foul ulcers, and for 
stino^s of insects. 



Fia. 190. 




BITTER-ROOT. 



Bitter-root (Apocynmn Androscemifolium). — An indigenous plant, 
growing in rich soils in the United States and 
Canada. The root is the part used, and is laxa- 
tive, tonic, diaphoretic, and alterative. It is em- 
ployed in chronic affections of the liver, syphilis, 
scrofula, intermittents, and the low stage of ty- 
phoid fevers. Forty to sixty grains will cause 
vomiting without much nausea. 

Preparations. — Fluid extract, dose, as a tonic, 
ten to twenty drops ; as a diaphoretic, fifteen to 
twenty-five drops ; as an emetic, half a dram 
to a dram. Solid extract, dose, two to eight 
grains ; apocynin, the active principle of the root, 
dose, half a grain to two grains; tincture, dose, 
two to three drams ; infusion, dose, a Avineglass- 
fnl, three times a day. 

Bismnth. — The principal preparation of this metal used in medi- 
cine, is the trisnitrate of bismutJi^ also called nitrate^ subnitrate, and 
irhite oxide of bismnth. It is a white powder, without smell or taste. 
It is used for various irritable and painful affections of the stomach, 
-^vhen there is no acute inflammation. It is particularly useful in 
c hronic diarrhcea, more especially the diarrhoea of the latter stages of 
consumption, — over lohich it has more control than any other known 
remedy. To show its best effects in this form of diarrhoea, it should 
be given in large doses, not less than twenty to thirty grains, immedi- 
ately after each meal. The small doses usually given are compara- 
tively useless. Given in these full doses, it is also almost a specific 
in heartburn and water-brash. The unpleasant symptoms spoken of 
in books, as arising from large doses, are fabulous. 

Bittersweet (Solanum Dulcamara). — This is common in Europe 
and North America. It is a woody vine, the roots and stalks of which 
are used in medicine. It is shghtly narcotic, and has alterative and 
diaphoretic properties. It is used in scaly and syphilitic affections of 
the skin. It is said to have antephrodisiac properties, and is servicea- 
ble in mania, connected with strong venereal propensities. 

Preparations. — Fluid extract, dose, half a dram to a dram; solid 



;96 



MEDICINES AND THEIR PREPARATIONS. 



extract, dose, three to eight grains ; infusion, dose, one to three ounces, 
three or four times a day. 

Black Alder {Prinos Verticillains). — This shrub is common in the 
United States ; its bark and berries are used. It has been found use- 
ful in jaundice, diarrhoea, intermittent fever, and other diseases con- 
nected with debility. Applied locally in the form of a wash or 
poultice, and given internally, it is popular in chronic eruptions of the 
skin, and in flabby, ill-conditioned ulcers, and mortification. 

Preparations. — Fluid extract, dose, two drams; tincture, dose, two 
to four drams. 

Two drams of the fluid extract of black alder, one dram of the 
fluid extract of golden seal, and one pint of water, mixed, and taken 
in doses of four fluid ounces, three or four times a day, are valuable 
in dyspepsia. 

Blackberry (Ruhus Villosus). — There are many species of this 
growing in the United States. The bark of the root is the part used. 
It is tonic, and strongly astringent, and is a valuable remedy in diar- 
rhoea, dysentery, cholera-infantum, relaxed condition of the bowels of 
children, and the passive discharge of blood from the stomach, bowels, 
and womb. 

Preparations. — Fluid extract, dose, half a dram to a dram; solid 
extract, four to six grains ; tincture, dose, two to four drams ; infu- 
sion, dose, one ounce. This last preparation is also* useful as an injec- 
tion in gleet, leucorrhoea, and prolapsus of the rectum and womb. 
The syrup of the blackberry root is also a valuable preparation ; so 
also is blackberry brandy, so called, which is the juice of the fruit 
mixed with brandy. This is excellent in summer complaints. 





Fig. 191. 


1 


I^^^T^V^^^^I 


B 


|B^^ 


Hi 




1 





Fig. 192. 




BLACK COHOSH. 



BLOODKOOT. 



Black Cohosh (Cimicifvga Racemosa). — This grows in rich soils 
throughout the United States. The root is the part used. It is 
slii^htly narcotic, sedative, antispasmodic, antiperiodic, and exerts a 



marked influence over th 



e nervous system ; being useful in St. Vitu&'s 



MEDICINES AND THEIR PREPAIIATIONS. 



097 



dance, epilepsy, nervous excitability, asthma, delirium tremens, and 
many spasmodic affections. It has an especial affinity for the uterus. 

It reduces the arterial action very materially, and hence is useful 
in palpitation of the heart. It has been used successfully in acute 
rheumatism, but more particularly in chronic rheumatism. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
solid extract, dose, four to eight grains ; tincture, four ounces to the 
pint of alcohol; dose, one to three drams; cimicifugin, the active 
principle, dose, one to six grains. 

Bliick Willow (Salix Nigra). — This tree is found in the Northern 
States, along the banks of rivers, especially in New York and Penn- 
sylvania, and is known by the common name of pussy willow. It is 
a bitter tonic, and is sometimes used in fever and ague. A decoction 
made from the buds, is said to be a powerful antaphrodisiac, and is 
accordingly useful in the treatment spermatorrhea. 

Bloodroot (Sanguinaria Canadensis). — A perennial plant, growing 
in light, rich soils, in most parts of the United States. The root is 
the part used. It is emetic, narcotic, expectorant, alterative, escha- 
rotic, and errhine. It is used in typhoid pneumonia, bronchitis, rheu- 
matism, dyspepsia, etc. Three to five grains stimulates the digestive 
organs, and accelerates the pulse. 

Preparations. — Fluid extract, dose, five to fifteen drops ; solid ex- 
tract, half a grain to a grain and a half; tincture, twenty drops to a 
dram; sanguinaria, the alkaloid principle, from one twentieth to one 
tenth of a grain ; sanguinarin, the resinous principle, one quarter to 
one grain. 

Four-grain pills, made of sanguinarin, twelve grains, caulophyllin, 
twelve grains, solid extract of cimicifuga, twelve grains, are said to be 
efficacious in amenorrhoea, dysmenorrhoea, and other female disorders. 




Fig. 194. 




BLUE COHOSH. 



BLUE FLAG. 



Blue Cohosh {Caulophylluni Tlialictroides). — A perennial plant, 
growing in low, moist grounds in most parts of the United States. 



598 MEDICINES AND THEIR PREPARATIONS. 

The root is the part used. It is antispasmodic, diuretic, diaphoretic, 
alterative, emmenagogue, anthelmintic, parturient, and tonic. It is 
used in rheumatism, dropsy, epilepsy, hysterics, cramps, amenorrhoea, 
dysmenorrhoea, chorea, leucorrhoea, hiccough, to hasten delivery, and 
to relieve after-pains. 

Preparations. — Fluid extract, dose, fifteen to forty drops ; solid 
extract, dose, one to five grains ; tincture, dose, half a dram to a 
dram ; infusion, dose, two to four ounces ; caulophyllin, the active 
principle of Ihe root, dose, one quarter of a grain to two grains. 

In cases of protracted labor, occasioned by fatigue or debility, the 
infusion is said to be fully equal to ergot in hastening delivery. A 
wash made by combining one ounce of fluid extract with one ounce 
of the fluid extract of golden seal, and eight ounces of water, is very 
excellent for apthous sore mouth. 

Blue Fla«' (7m Versicolor). — A perennial plant, growing in damp 
places, in most parts of the United States. The root is the part used 
for medicinal purposes. It is cathartic, alterative, sialagogue, and 
diuretic. It acts particularly on the glandular system ; in large doses, 
it evacuates and exhausts the system, acting on the liver, and fulfill- 
ing the purposes of mercury. 

Preparations. — Fluid extract, dose, twenty to sixty drops ; solid 
extract, one to four grains ; tincture, one to two drams. Iridin, the 
active and resinous principle, dose, half a grain to four grains. Equal 
parts, of blue flag, mandrake, and prickly-ash bark, mixed, and given 
in five to ten-grain doses, every two or three hours, will act as a pow- 
erful alterative, and cause free salivation, without making the breath 
ofi'ensive or injuring the gums. Three grains of iridin, five grains of 
leptandrin, and twenty grains of bitartrate of potassa, form an excel- 
lent cathartic in dropsy, producing free watery stools. 

Blue Pill (Ihjdrargyri Pilulce). — -This mercurial preparation, g(M]- 
erally known by the common name of blue mass, or blue pill, is made 
by rubbing mercury, confection of roses, and pulverized liquorice-root 
together until all the mercurial globules disappear. The mass is di- 
vided into pills when wanted. It is the mildest of all the mercurial 
preparations, and the least liable to produce salivation or irritation 
of the system. But even this should be used sparingly, and with 
caution. 

The blue mass is alterative and cathartic, and is considerably given 
to stimulate the action of the liver, and to produce an alterative eflect 
upon the digestive organs. The leptandra and the podophyllum have 
become its rivals, and will, I sincerely hope, finally take its place. 

Boueset {Eupatorium Perfoliatum). — An indigenous plant growing 
in most parts of the United States. The tops and leaves are medic- 
inal. It is tonic, diaphoretic, expectorant, and, in large doses, or 
when taken as a warm infusion, emetic, and aperient. 

Preparations. — Fluid extract, dose, one to two drams; solid extract, 
dose, five to twenty grains ; tincture, dose, one to two ounces ; infu- 
sion, dose, one to three ounces. Eupatorin, dose, one to three grains. 



^lEDICINKS AXD THEIR PREPARATIONS. 



599 



Two scruples of eupatorin, one scruple of xaiithoxylin, and one grain 
of strychnia, mixed, and made into twenty powders, is excellent for 
torpor of the liver, or kidneys, and for rheumatism; one powder being 
taken three or four times a day. 




Fig. 196. 




Bucliu {Barosma Crenata). — It grows at the Cape of Good Hope. 
The leaves are the medicinal portion ; they are stimulant, diuretic, 
antispasmodic, and tonic. Buchu is chiefly given in complaints of 
the urinary organs, attended with increased uric-acid gravel, chronit-. 
inflammation or morbid irritation of the bladder, urethra, and prostate, 
and retention, or incontinence of urine. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
tincture, dose, two to six drams ; infusion, one to six ounces. A com- 
bfnation of fluid extract of buchu, half an ounce ; acetate of potash, 
two drams ; and water, eight ounces, taken in doses of four ounces, 
three or four times a day, is a valuable diuretic. 

This combination, however, may be improved by the addition of a 
little sweet spirits of nitre. 

Buckhorn Brake (Osmunda Regalis). — This is a fern growing in 
moist grounds in most parts of the United States. The root, which 
is the medicinal part, should be gathered in the latter part of May, and 
in August, and very carefully dried, to prevent moulding. It is mucil- 
aginous and tonic, and is used in coughs, diarrhoea, and dysentery, and 
as a tonic w^hile getting up from exhausting disease. One root infused 
in a pint of hot water for half an hour will convert it into a thick jelly. 
This mucilage may be sweetened with sugar, and freely taken. 

Buckthorn (Rhamnus Catharticus). — This plant grows in Europe, 
where it is much esteemed by practitioners. The berries and juice 
are actively medicinal. It is a powerful cathartic, producing large 
watery discharges. It is seldom used alone on account of the severity 
of its action. 

Preparations. — Fluid extract, dose, one dram ; syrup of buckthorn, 
made by uniting four ounces of fluid extract with twelve ounces of 
simple syrup, dose, two drams. 



GOO Mi:i)iciNi: s and their preparations. 

Bug'leweed (Lycopus Virginicus). — This grows ia shady and wet 
places throughout a greater part of the United States. The whole 
herb is used. It is a mild narcotic, sedative, sub-astringent, and styp- 
tic. It is a valuable remedy in bleeding from the lungs, incipient 
consumption, and pneumonia. It quiets irritation, and allays cough, 
and nervous excitement. 

Preparations. — Fluid extract, dose, one to two drams ; infusion, 
dose, two to four ounces. 

Burdock (Lappa Mhwr). — A native of Europe, and growing in the 
United States. The root is used, which is useful in scurvy, syphilis, 
scrofula, gout, leprosy, and disease of the kidneys. It needs to be 
used for a long time. It is said to be useful for persons afflicted with 
boils, stye, etc. An ointment prepared from it is serviceable in some 
diseases of the skin, and obstinate ulcers. 

Preparations. — Fluid extract, dose, one dram ; solid extract, dose, 
five to twenty grains; tincture, dose, half an ounce to an ounce. 

Buro'uiidy Pitch. — This is the concrete juice of the Norway pine, 
ahies excelsa, growing in Europe and Northern Asia, and of the silver 
fir tree of Europe, abies picea. It gently excites the skin, and is used 
chiefly in the form of plasters, either alone or mixed with other gums 
and resins. 

Butternut [Juglans Cinerea). — This is a forest tree, growing in 
various parts of the continent, knowm also by the names of oiinut, 
and white walnut. The inner bark of the root is used, and is a mild 
cathartic, — being useful in cases of constipation. It is much employed 
by families, as a domestic remedy, in intermittent and remittent fevers. 
It evacuates the bowels without debilitating them. 

Preparations. — Fluid extract, dose, one to two drams ; solid ex- 
tract, dose, five to twenty grains; juglandin, the active principle, dose, 
one to five grains. A very good pill is made by mixing one and a 
quarter drams of the solid extract of butternut, three quarters of a 
dram of the solid extract of jalap, and ten grains of soap, and divid- 
ing the whole into sixteen pills. From two to five may be taken for 
a dose. 

Calcined Beer's Horn [Cornu Cervince Ustum). — The horns of the 
deer are said to be in velvet between August and December, and dur- 
ing this period, those which faU are collected, coarsely rasped, and 
placed in an iron vessel, which is tightly covered, and placed in an 
oven, or elsewhere, and subjected to a heat of 200° F., which is con- 
tinued until the rasped horn becomes of the color of roasted coflee. 
When cooled, it is reduced to powder by trituration, and preserved in 
closely stopped vials. It is a powerful styptic, taken in teaspoonful 
doses, every half hour ; or, a teaspoonful added to a gill of hot water, 
and a tablespoonful of this taken every five or ten minutes. It has 
much efficacy in floodings from the womb, and in excessive menstru- 
ation. 

CsUomel (Hi/drargyri Chloridum Mite). — This is prepared Trom 
meicury, sulphuric acid, and common salt. It is alterative, aniisyp[ii> 



MEDICINES AND THEIR PREPARATIONS. 



601 



Fig. 197. 



litic, and anthelmintic, and, in large doses, purgative. It is much 
used in venereal diseases, and chronic affections of the liver, combined 
with opium ; in dropsies, combined with squill, foxglove, and elate- 
rium ; and in rheumatism and leprosy, combined with antimonials, 
guaiacum, and other sudoritics. In the beginning of fevers and other 
complaints, it is often combined with purgatives, as gamboge, scam- 
mony, jalap, and rhubarb. Given in small doses, not large enough to 
purge, it gradually excites salivation. Dose, from one to ten grains. 

The tendency of this article to produce salivation, to injure the 
gums, loosen the teeth, etc., has given rise to much prejudice against 
it in the public mind ; and, indeed, it must be confessed that it has 
been used by many, from time immemorial, with great indiscretion. 
In the hands of sensible and prudent men, it is very serviceable in 
some cases ; but the podophyllum and leptandra have so fine an action 
upon the liver, that they are fast taking the place of calomel and other 
mercurials, and possibly may in time wholly supersede them. I have 
prescribed calomel but two or three times in this book, and am willing 
to see it banished from the materia medica, as 
soon as the careful investigations of science 
shall find cause to decree its expulsion. 

Ciliiiplior. — This is obtained from an ever- 
green tree, growing in the East Indies, — the 
laurus camphora. It is a white, shiny, crystal- 
line substance, extracted from the wood and 
roots of the above named tree, by boiling them, 
and is subsequently purified by sublimation. 
It has a penetrating, peculiar diffusible odor, 
and a pungent, cooling taste. It is moderately 
stimulant, diaphoretic, and antaphrodisiac. Dose, 
from one to ten grains. 

Canada Bulsam. — This is the fluid obtained 
from the fir balsam, abies balsamea^ of Canada, 
Maine, etc. It is a stimulating diuretic, and, in large doses, cathartic. 
A dose is from ten to twenty drops, two or three times a day, in pills, 
or in emulsion. It forms a part of several ointments and plasters. It 
is used to mount objects in microscopic investigations. 

Canada Fleabane (Erigeron Canadense). — An annual plant, grow- 
ing in the Northern and Middle States. It is diuretic, tonic, and 
astringent, and has been found useful in dropsical complaints, and 
diarrhoea. The dose of the powder is from thirty grains to a dram ; 
of the infusion, from two to four fluid ounces ; of the solid extract, 
from five to ten grains ; to be repeated, in each case, every two or 
three hours. 




CAMPHOR TREE. 



Canella (Cane I la Alba). — This is the bark of a South American 
tree, and is an aromatic stimulant, and a gentle tonic, and useful in 
debility of the stomach. 

Caraway (Cariim Carui). — This biennial plant grows in Europe. 
The seeds are the part used, and are aromatic and carminative ; tlfey 

76 



G03 MEDICINES AND THEIR PREPARATIONS. 

are used in wind colic, and to improve the flavor of other medicine. 
The dose is from ten to sixty grains. The dose of the oil of caraway, 
extracted from the seeds, is from one to ten drops. 

Cardiiiiiom (Alpinia Cardamomum). — This plant grows on the 
mountains of Malabar. The seeds, which are the medicinal parts, are 
aromatic, and carminative, and are used to expel wind, and to flavor 
medicines. Dose, from ten grains to two drams. The volatile oil 
obtained from them has similar properties. 

CascarilLl. — This medicine is the bark of the West India shrub, 
croton eleiUeria. It has an aromatic odor, and a warm, spicy taste. 
It is a pleasant aromatic and tonic, and is used in dyspepsia, chronic 
diarrhoea and dysentery, wind colic, and other debilities of the stom- 
ach and bowels. It counteracts the tendency of cinchona to' produce 
nausea. 

Preparations. — Fluid extract, dose, twenty to thirty drops; tincture, 
dose, one dram ; infusion, dose, one to three drams. An alkaline infu- 
sion, composed of fluid extract, three ounces ; carbonate of potassa, 
two drams ; and water, ten ounces, is excellent in weak stomach, with 
acidity. Dose, one dram. 

Castor ( Castorewn). — A peculiar substance obtained from the bea- 
ver. It is antispasmodic and emmenagogue. It is used in typhus, 
hysterics, epilepsy, retention of the menses, and in many other ner- 
vous diseases. Dose, from ieu. to twenty grains. A medicine of no 
great value. 

Castor Oil (Oleum Richii). — This is obtained by expression from 
the seeds of the castor oil bush, ricinus communis. When exposed to 
the air, it turns rancid, and spoils. 

As a mild cathartic, this oil is extensively used, particularly among 
children. It is an exceedingly nauseous medicine, but may be ren- 
dered less offensive by being mixed with a few drops of oil of winter- 
green, peppermint, or cinnamon ; and its bad taste may be nearly 
destroyed by rubbing it up to a thick batter with carbonate of mag- 
nesia. Or, if boiled a few minutes with a little sweet milk, sweetened 
with loaf sugar, and flavored with essence of cinnamon or pepper- 
mint, it may be easily taken. Dose, for an adult, one to three table- 
spoonfuls ; for a child, one, two, or three teaspoonfuls, according to 
its age. 

Catechu. — This is a solid extract, made from the wood of the 
acacia catechu^ a tree growing in Asia. It is in dark, brown, and 
brittle pieces, and is soluble in alcohol. It is a powerful astringent, 
and is used in chronic diarrhoea, and chronic dysentery. It makes a 
useful gargle in some forms of sore mouth, in elongated uvula, spongy 
gums, and sore nipples. The dose of the powder is from ten to thirty 
grains, and of the tincture, from one to two teaspoonfuls. 

Catnip {Nepeta Cataria). — A native of Europe, and widely natural- 
ized in this country. The tops and leaves are the medicinal part, and 
are carminative and diaphoretic when drank as a warm infusion. It 



MEDICINES AND THEIR TREPARATIOXS. 603 

is useful in fevers, in wind colic, nervous headache, hysterics, and ner- 
vous irrirability. 

Preparations. — Fluid extract, dose, two to four drams; infusion, 
dose, two to four ounces. Fluid extract of catnip, two ounces ; and 
the fluid extract of saffj-on, one ounce and a half, united, make a 
popular remedy for colds, and the rashes of children. In nervous 
complaints, a combination of fluid extract of catnip, six drams ; fluid 
extract of valerian, four drams ; and fluid extract of scullcap, four 
drams, is a valuable remedy. Dose, one to three drams. 

Ciiveuiie Pepper {Capsicum Annuum). — This plant grows in hot 
climates, and is known by the common name of red pepper. The 
berry, which is the part used, has an intensely hot and pungent taste. 
It is a powerful, diffusible stimulant, and is about the only stimulus 
which the t^tomach will bear in certain forms of dyspepsia. It is use- 
ful in all cases of diminished vital action, and is frequently united 
with other medicines, either to promote their action, or to lessen the 
severity of their operation. It is much used in colds, hoarseness, etc., 
as it promotes a free discharge of mucus and phlegm. Taken in 
small doses, it has a fine eflect upon the mucous membrane of the 
stomach and bowels, lessening very much the severity of piles, and 
sometimes curing them. It may be sprinkled daily upon the food, or 
taken in the form of cayenne lozenges ; it is frequently useful as a 
gargle in sore throats, scarlet fever, etc. Dose of the powder from 
one to ten grains. 

Preparations. — Fluid extract, dose, five to fifteen drops; tincture, 
dose, half a dram to a dram, used in low forms of fever, and gastric 
insensibility ; infusion, dose, one to three drams. A valuable gargle 
in scarlet fever may be made by combining fluid extract of cayenne, 
one ounce ; common salt, one dram ; boiling vinegar, one pint ; boil- 
ing water, one pint. 

Celandine (Chelidonium Majus). — This plant is indigenous to 
Europe, and is extensively naturalized in the United States. It is a 
drastic purge, producing watery stools, and is equal to gamboge ; it is 
useful in attections of the liver, and particularly in those of the spleen. 
In the form of a poultice it is effective in scrofula, indolent ulcers, 
skin diseases, and piles. 

Preparations. — Fluid extract, dose, ten to twenty drops ; solid ex- 
tract, dose, five to ten grains ; tincture, dose, half a dram to a dram ; 
infusion, dose, two and a half to five drams. A very good hydra- 
gogue cathartic is made by compounding two and a half drams of 
fluid" extract of celandine, with half a dram of fluid extract of hen- 
bane, one ounce of sulphate of potassa, one grain of tartar emetic, 
six ounces of elder water, and ounce of syrup of squill. 

Chalk. — On account of its gritty particles, it is unfit for medicinal 
use until it has been levigated, after which it is called prepared chalk. 
This is the only form in which it is used in medicine. It is an excel- 
lent antacid, and is admirably adapted to diarrhoea, accompanied with 
acidity. The most convenient form of administering chalk is that of 



604 



MEDICINES AND THEIR PREPARATIOXS. 



the chalk mixture, which consists of prepared chalk, half an ounce ; 
sugar and powdered gum arable, two drams each ; cinnamon-water 
and water, four fluid ounces each, and rubbed together in a mortar 
till they are thoroughly mixed. Dose, a tablespoonful frequently re- 
peated. 



Fig. 198. 



Fig. 199. 







CAYZXNE PEPPER. 



CHAMOMILE. 



Cliamomile (Anthemis Nobilis). — This perennial plant grows in 
Europe, and its flowers are considerably used in medicine, the whitest 
of which are best. They are gently tonic, and are generally used in 
cold infusion, in cases of weak stomach, dyspepsia, etc. In large 
doses, the warm infusion will act as an emetic. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, four to twenty grains ; infusion, dose, half an ounce to 
an ounce. For dyspepsia, wind in the stomach, etc., thirty pills may 
be made, by combining one dram of solid extract of chamomile with 
five grains of the solid extract of rhubarb, and ten grains of assa- 
foetida, and taken, one pill at a time, two or three times a day, with 
advantage. 

Charcoal {Carbo Ligni). — Prepared charcoal is antiseptic and ab- 
sorbent, and is employed with great advantage, in certain forms of 
dyspepsia, attended with bad breath, and putrid eructations ; it has a 
good eftect in correcting the fetor of the stools in dysentery : it is con- 
siderably used, and with much advantage as an ingredient in poul- 
tices. Dose, when taken internally, from one to four teaspoonfuls. 

Chloroform (Chloroformum). — This is an anaesthetic, used to pro- 
duce insensibility during surgical operations. A teaspoonful or more 
is poured upon a handkerchief, which is held to the patient's nose, 
but not so closely as to prevent the admission of air. The numerous 
sudden di'aihs which have occurred from its use, prove it to be an 
unsafe agent, and it is now seldom employed by careful surgeons. 
Taken interii:il!y it is sedative and narcotic ; applied externally, com- 
bined with udier articles, it is useful in painful affections, as nervous 



MEDICINES AND THEIR PRErARATIONS. 605 

f ■ — ■ 

headache, rheumatism, neuralgia, etc. The dose when taken inter- 
nally, is from ten to sixty drops, in flax-seed tea. 

Cinnamon. — This is the bark of trees growing in Ceylon, Malabar, 
and iSuniatra. It is a very grateful aromatic, being warm and cordial 
to the stomach ; it is also carminative and astringent. 

It is not often prescribed alone, but is chiefly used as an aid to less 
pleasant medicines, and enters into a great number of preparations. 
It is peculiarly adapted to diarrhoea ; and in treating this complaint 
it is often joined with chalk and stringents. Dose of the bark, from 
ten to twenty grains. The oil has properties similar to those of the 
bark. 

Cassia Buds. — This spice is a product of China. It consists of the 
calyx surrounding the young germ of one or more species of cinna- 
mon. Cassia buds have some resemblance to cloves, and are com- 
pared to small nails with round heads. They may be used for the 
same purposes as the cinnamon bark. 

Cleiivers {Galium Aparine). — An annual plant, common to this 
country and Europe, having an acid, astringent taste. The whole 
herb is used in infusion, as a cooling diuretic, in scalding of the urine, 
inflammation of the kidneys and bladder, in gravel, suppression of the 
urine, etc. 

It is also used in fevers, and all acute diseases. The infusion is 
made by adding two ounces of the herb to a pint and a half of warm 
water. It should stand three or four hours, and be drank freely when 
cold. Equal parts of elder-blows, cleavers, and maiden-hair, infused 
in warm water, make a refreshing drink in scarlet fever, and other 
eruptive diseases. 

Cloves ( Caryophyllus Aromaticus). — The flowers of this tree, a 
native of tropical climates, collected before they are fully developed, 
form cloves. They are highly stimulant and aromatic, and are used 
to give tone to the digestive organs, particularly when flatulency 
exists, and to relieve nausea and vomiting. They are more generally 
employed to improve the taste and modify the action of other medi- 
cines. The dose in powder is from five to ten grains. The oil of 
cloves^ has similar properties; dose, two to five drops. A little cotton 
moistened with the oil, and pressed into a decayed tooth, will fre- 
quently relieve the toothache. 

Cochineal (Coccus Cacti). — An insect found in Mexico, inhabiting 
different species of cactus. They are gathered for use by detaching 
them from the plant with a blunt knife, and dipping them, enclosed 
in a bag, into boiling water. Cochineal is anodyne, and has been 
used with advantage in hooping-cough and neuralgia. It is much 
used for coloring tinctures, and ointments, and the color called car- 
mine is prepared from it. A tincture is prepared by macerating two 
ounces of cochineal, in one pint of alcohol, for seven days, and filter- 
ing through paper. Dose, from twenty to thirty drops, twice a day. 

Cod Liver Oil [Oleum Morrhuw). — This oil is obtained from the 



606 MEDICINES AND THEIR rilEPARATIONS. . 

livers of codfish, and is nutritive and alterative. It is a popular rem- 
edy in consumption and scrofula, and in those complaints generally 
in which there is impaired digestion, assimilation, and nutrition. 
Dose, a tablespoonful three times a day. 

Inability to digest this oil, to eat fat meats, or to take fats in any 
form, is an unfavorable indication in consumption. 

Collodion. — This is gun-cotton dissolved in ether. It is applied 
with a camel's-hair brush, to cuts, burns, wounds, leech-bites, etc., 
over which it forms a thin pellicle or skin, protecting the injured part 
from the atmosphere. It should be kept in well stopped bottles, to 
prevent its evaporating and becoming unfit for use. 

Colocjiitli ( Cucumis Colocynthis). — A native of northern Africa. 
The part used in medicine is the fruit, deprived of its rind. It is a 
powerful drastic, hydragogue cathartic ; causing by its harsh action, 
griping, vomiting, and sometimes bloody discharges; from the severity 
of its operations, it is rarely used alone. Useful in dropsy, derange- 
ments of the brain, and for overcoming torpid conditions of the diges- 
tive and biliary organs. 

Preparations. — Solid extract, dose, two to thirty grains ; compound 
extract, dose, two to thirty grains. 

Colombo (Cocculus Palmatus). — A perennial climbing plant, grow- 
ing in east Africa, and cultivated in the Isle of France. It is a pure, 
bitter tonic, and is used in dyspepsia, bilious vomitings which attend 
pregnancy, and during recovery from exhausting diseases. 

Preparations. — Fluid extract, dose, twenty to sixty drops ; solid 
extract, dose, four to ten grains ; tincture, dose, one to four drams ; 
infusion, dose, three drams to an ounce. A compound infusion made 
by uniting one dram of fluid extract, four drams of orange peel, and 
one ounce of water, is useful in a weakened state of the bowels, 
showing itself in a diarrhoea. Dose, two drams every hour. Fluid 
extract of Colombo, one ounce ; fluid extract of ginger, two drams, 
and water, one pint, also make a useful compound for the same pur- 
pose. Fluid extract of Colombo, one dram ; fluid extract of rhubarb, 
one dram; fluid extract of ginger, half a dram; water, one pint, — 
this is useful for a like purpose. The following is also a very good 
preparation for a similar use : fluid extract of Colombo, half an ounce ; 
fluid extract of cascarilla, two drams ; tincture of orange peel, two 
drams ; syrup of cinnamon, one ounce ; water, six ounces. Dose, one 
dram every hour. 

Coltsfoot (Tussilago Farfara). — A native of Europe, and natural- 
ized in this country, especially in the Northern States. It grows in 
wet places, and low meadows. The leaves are principally used. 
They are emollient, demulcent, and slightly tonic; used in coughs, 
asthma, and hooping-cough ; and externally in the form of poultice 
for scrofulous tumors. 

Coiiifrey (Symphytum Officinale). — A perennial European plant, 
cultivated in this country. The root is the part used. It is demul- 



MEDICINES AND THEIR rUEPARx\.TIONS. 607 

cent, and slightly astringent, and is serviceable in diseases of the 
mucous tissues, and in scrofulous habits ; also in diarrhoea, dysentery, 
coughs, bleeding from the lungs, whites, etc. It may be taken as an 
infusion, or as a syrup, one ounce to a pint of water; the dose being 
one to four fluid ounces, three to four times a day. The fresh root 
bruised forms a valuable application to ulcers, bruises, fresh wounds, 
sore breasts, and white swellings. '* 

Common Silk- Weed (Asclepias Syriaca). — This is a perennial plant, 
common throughout the United States. It gives out a- milky juice 
upon being wounded, and hence is often called milk-weed. The root 
is diuretic, alterative, emmenagogue, and anodyne ; and is sometimes 
used in dropsy, retention of urine, suppressed menstruation, scrofula, 
and rheumatism. Dose of the powder, from eight to twenty-five 
grains ; of the decoction, from one to three fluid ounces. 

Copper {Cuprum). — The following are the principal salts of copper 
used in medicine. 

Subacetrtte of Copper (Cupri Subacetas). — This is known by the 
name of verdigris, and is used as a detergent and escharotic ; it, is 
applied to warts and fungous growths, and to foul ulcers and ring- 
worm. When reduced to a line powder, by trituration in a porcelain 
mortar, the finer parts of this are separated, and called prepared sub- 
acetate of copper ; this is the preparation used for the purposes above 
named. 

Sulphate of Copper {Cupri Sulphas). — In small doses, the sulphate 
of copper is astringent and tonic ; in large ones, a prompt emetic. It 
is given in small doses in hysterics, epilepsy, and intermittent fevers ; 
and in large doses, to produce speedy vomiting in croup, and to eject 
])oisons from the stomach. A weak solution is sometimes used for 
syphilitic ulcers, and as an injection in gleet. Dose, as a tonic, one 
quarter of a grain to two grains, in pill ; as a rapid vomit, from two 
to ten grains, in two ounces of water. The medicines which are in- 
compatible with copper, are alkalies, earths, and their carbonates, 
borax, salts of lead, acetate of iron, and astringent vegetable infu- 
sions, decoction?, and tinctures. 

Corrosive Sublimate. — This, in chemical language, is the bichlo- 
ride of mercury. It is one of the milder mercurial preparations, 
although when taken in large doses, it is a violent poison, and oper- 
ates very quickly. It is less apt to salivate than any other mercurial, 
except blue pill. It is much used as a remedy in syphilis, particu- 
larly in the secondary stage, in which, in many cases, it does much 
good. It is also popular in many skin diseases, as leprosy. When 
employed for this purpone, it is generally associated with alterative 
and diaphoretic medicines, such as the compound decoction or syrup 
of sarsaparilla, preparations of yellow dock, etc. In order to avoid 
its irritating effects, it is often united with opium, or extract of conium. 
Dissolved in w^ater, it is valuable as a wash in some skin diseases. It 
is an ingredient in many of the quack nostrums which are extensively 



608 



MEDICINES AND THEIR PREPARATIONS 



Fig. 200. 



advertisec^, and was the active principle in Swaim's Panacea, which 
had so vast a sale a few years since, and gave such a princely fortune 
to its proprietor. One ounce of corrosive sublimate, dissolved in one 
quart of alcohol, is a complete bed-bug exterminator. 

Cotton (Gossypium Herbacenm). — Cotton is chiefly employed in 
cases of recent burns, and scalds, — an application of it, which sur- 
geons have, learned from popular use. It diminishes the inflamma- 
tion, prevents blistering, and hastens the cure. It is applied in thin 
and successive layers. The inner bark of the root is said to be em- 
menagogue, parturient, and abortive. A decoction of it, made by 
boiling four ounces of the inner bark of the root in a quart of water, 
down to a pint, is said to be given in wineglassful doses by the female 
slaves of the South, for the purpose of producing abortion. It is ex- 
cellent in chlorosis. 

Preparation. — Fluid extract, dose, four drams. 

Craiiasbill {Geranium^ Maculatum). — An indigenous plant, growing 
in all parts of the United States, in the open woods. The root is the 
medicinal part. It is a powerful astringent, 
similar to kino, and catechu, and a valuable 
substitute for those articles, because less ex- 
pensive. It forms an excellent gargle in sore 
throats and ulcerations of the mouth, and is 
valuable for treating those discharges arising 
from debility, after the exciting causes are 
i-emoved. It has no unpleasant taste, and is 
therefore well adapted to infants, and persons 
of delicate stomachs. As an injection, it is 
used in gleet, and whites. 

Preparations. — Fluid extract, dose, half a 
dram to a dram ; solid extract, dose, three to 
fifteen grains ; geraniin, the active principle, 
dose, one to five grains ; tincture, dose, two 
and a half to four drams ; infusion, dose, one 
to two ounces. A valuable astrins^ent wash 
for sore mouth, etc., and as an injection in leucorrhcea, etc., is made 
by uniting fluid extract of cranesbill, half an ounce ; fluid extract of 
black cohosh, half an ounce ; fluid extract of golden seal, half an 
ounce ; fluid extract of witch-hazel, half an ounce ; and water, one 
quart. Geraniin, dioscorein, and caulophyllin, united in equal parts, 
and given to an adult in six-grain doses, every fifteen or twenty min- 
utes, have an excellent effect in diarrhoea and cholera-morbus, when 
there is much pain and rumbling of the bowels. 




CRANESBILL. 



Crawley {Corallorhiza Odontorhiza). — A perennial plant, growing 
on barren hills and hard clay soils in New York. The root is the 
part used. It is sedative and diaphoretic, and is used in inflamma- 
tory diseases, and in typhoid fever; also in flatulency, cramps, hectic 
fever, and night sweats. When the liver requires to be acted upon, 
it should be combined with mandrake or Culver's root. The powdered 



MEDICINES AND THEIR PREPARATIONS. 609 

root should be kept in well-stopped vials ; its dose is from twenty to 
thirty grains, in warm water, every hoar or two. 

Creosote (Creosotum), — This is obtained by the distillation of tar. 
It is irritant, narcotic, styptic, antiseptic, and moderately escharotic. 
It has been given in diabetes, epilepsy, hysterics, neuralgia, bleeding 
from the lungs, and chronic bronchitis. It is an excellent remedy for 
arresting nausea and vomiting, when not dependent on inflammation. 
The dose, when given internally, is one or two drops. It is rhost easily 
taiven in the form of pill. In some forms of bronchitis, the vapor of 
creosote is "inhaled with advantage. It may sometimes be applied 
with excellent eflect, to indolent or ill-conditioned ulcers, in which case,' 
two, four, or six drops may be dissolved in an ounce of distilled water. 
In some cases the solution is mixed with poultices. One or two 
drops of pure creosote, introduced into a hollow tooth on a little cot- 
ton, is generally a speedy remedy for toothache, but great care must 
be taken that it does not come in contact with the tongue or cheek. 

Crotoii Oil (Oleum Tig-Iii). — This is obtained from the seeds of the 
C rot on Tlg-Iium, a plant growing in the East Indies. It is a powerful 
cathartic, producing watery stools, and is used in torpidity of the 
bowels, dropsy, apoplexy, mania, inflammation of the brain, hydro- 
cephalus, coma, and wherever a powerful revulsive action is needed 
to call the blood away from the brain. A drop placed on the tongue 
of a person in the comatose state, will generally operate. Two to six 
drops, rubbed upon the skin, produce an eruption or pimples in twelve 
hours. In this way, it is used in diseases of the throat and chest, and 
some other affections. If the skin is very sensitive, let it be combined 
with an equal quantity of sweet oil. 

Cubebs (CuhebcB). — A climbing perennial plant, growing in the 
East Indies. The berries are the medicinal part. They are stimu- 
lant, purgative, and diuretic, acting particularly upon the urinary 
organs, and arresting discharges from the water pipe, and much used 
in tlie treatment of gonorrhoea and gleet. It should not be used dur- 
ing active inflammation. Dose of powdered cubebs, from thirty to 
sixty grains. 

Preparations. — Fluid extract, dose, half a dram to a dram and a 
half ; ethereal fluid extract, dose, one to two drams ; solid extract, 
dose, two to twenty grains ; tincture, dose, one to two drams. A 
compound, made of fluid extract of cubebs, five drams ; fluid, extract 
of ergot, one and a half drams ; cinnamon water, half a dram ; and 
powdered loaf sugar, one dram, may be taken with advantage in 
gonorrhoea, gleet, and leucorrhoea ; dose, one dram. 

Culver's Root (Leptandra Virginica). — A perennial plant growing 
throughout the United States in limestone districts, and flowering in 
July and August. The root is the medicinal part. It is frequently 
called black root. When dried, it is tonic, cholagogue, and laxative, 
and is a very valuable remedy in affections of the liver, as it acts 
upon this organ with energy, without purgation. It is also useful in 
typhoid fevers, and in dyspepsia, diarrhoea, and dysentery. A powder 

77 



GIO 



MEDICINES AND THEIR PREPARATIONS. 



is made from it, containing its active principle, and called leptandrin, 
which has a fine effect in diarrhoea, cholera infantum, typhoid fever, 
some forms of dyspepsia, and in all diseases connected with derange- 
ments of the liver. 

Preparations. — Fluid extract, dose, one third of a dram to a dram ; 
leptandrin, the active principle, dose, in acute cases, one fourth of a 
grain to one grain ; in chronic cases, one to two grains ; tincture, two 
ounces to a pint of alcohol, dose, one dram to one ounce. 

Dandelion {Taraxacum^ Dens-Leonis), — This perennial herb is diu- 
retic, aperient, and tonic. It is generally thought to act especially 
upon the liver. Used in dyspepsia, diseases of the liver and spleen, 
and in debilitated and irritable conditions of the stomach and bowels. 

Preparations. — Fluid extract, dose, one to two drams ; compound 
fluid extract, dose, one to two drams ; fluid extract of dandelion and 
senna, dose, one to two drams ; solid extract, dose, ten to twenty 
grains ; infusion, two ounces to one pint of water, dose, four to six 
ounces. In dropsical affections, the following compound infusion will 
be found useful : fluid extract of dandelion, six drams ; fluid extract 
of rhubarb, one and a half drams ; fluid extract of henbane, twenty- 
four drops ; bicarbonate of soda, half a dram ; tartrate of potassa, 
three drams ; water, three and a half ounces ; take one third, three 
times a day. For jaundice, and diseases of the liver and kidneys, 
Ihe following pills have much efficacy. Solid extract of dandelion, 
one dram ; solid extract of bloodroot, one dram ; leptandrin, one scru- 
ple ; podophyllin, five grains ; oil of peppermint, fiv^e minims ; to be 
divided into fifty pills, and one or two taken three times a day. 



Fio. 201. 



Fig. 202. 





DEADLY NIGHTSHADE. 



Deadly Xig'litsliade (Atropa Belladonna). — A perennial plant, grow- 
ing in Europe and this country, and having a faint odor, and a sweet, 
nauseous taste. It is narcotic, diaphoretic, and diuretic ; is a valuable 
remedy in convulsions, neuralgia, hooping-cough, rheumatism, gout, 
paralysis, and many diseases having their seat in the nervous system. 
It has been much praised as a preventive of scarlet fever, though its 
powers for this purpose are doubtful. 

Preparations. — Fluid extract, dose, five to ten drops ; solid extract, 
dose, one quarter to one grain ; tincture, two ounces to a pint of 



MEDICINES AND THEIR PREPARATIONS. 611 

diluted alcohol, dose, from fifteen to thirty drops. The solid extract is 
used, mixed with lard or with other substances, as a local application 
for relieving pain, dilating the pupil of the eye, for removing stricture 
of the urethra, the anus, rigidity of the mouth of the womb, etc. 

Do^'wood {Cornus Florida). — This is a small tree growing most 
abundantly in the Middle States. The bark is used as a medicine. 
It is tonic, astringent, antiperiodic, and stimulant. It increases the 
frequency of the pulse, and elevates the temperature of the body. It 
has been substituted for peruvian bark in intermittent fevers. Dose 
of the powdered bark, from ten to sixty grains. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
solid extract, dose, five to ten grains ; tincture, four ounces to a pint 
of alcohol, dose, one to four drams ; infusion, two ounces to a pint of 
water; dose, half an ounce to two ounces; cornin, the active principle, 
dose, one to ten grains. 

DwiU'f Elder (Aralia Hispida). — A perennial under-shrub, growing 
from New England to Virginia. The bark of the root is diuretic and 
alterative. An infusion made from it is used in gravel, suppression 
of urine, and dropsy ; to be taken in wineglassful doses, three or four 
times a day. 

Elder (Samhucus Canadensis). — The flowers, berries, and inner 
bark of the elder, are used in medicine. A warm infusion of the 
flowers is diaphoretic, and gently stimulant. A cold infusion is diu- 
retic, alterative, and cooling ; used in erysipelas, liver affections of chil- 
dren, rheumatism, scrofula, and some syphilitic diseases. The bark, 
pounded with lard, forms a useful ointment for burns and scalds, and 
some diseases of the skin. 

Elecampane {Inula Helenium). — This perennial plant is a native of 
Europe and Japan, and is cultivated in this country. The root is 
stimulant, tonic, diuretic, and expectorant, and is used in chronic 
affections of the lungs and air passages. It is said a decoction from 
the root forms a good application for the itch, and other skin diseases. 
Dose of the powdered root, from a scruple to a dram ; of the infusion, 
one or two fluid ounces. 

Electro-Ma g'lietism. — Within a few years, electro-magnetism has 
been employed extensively as a remedial agent, particularly in the 
various forms of nervous disorders. That it is a valuable agent in the 
treatment of disease, few thinking physicians doubt ; yet, like most 
other new things in medicine, it has had its enthusiastic admirers, 
who have claimed for it remedial powers beyond what it really has, 
and who have applied it to purposes beyond its sphere of usefulness. 
Various instruments have been constructed for applying this remedy, 
but no one has appeared to me so well adapted to its purpose, as that 
manufactured by Messrs. Hinds & Williams, of this city. 

Feverfew {PyrefMum Partheniwn). — In warm infusion, this herb is 
valuable in recent colds, flatulency, worms, irregular menstruation, 



G12 



MEDICINES AND THEIR PREPARATIONS. 



hysterics, and suppression of the urine. The cold infusion is a tonic. 
A poultice made of the leaves, soothes and alleviates pain. 

Fio'wort (Scrophidaria Nodosa). — The leaves and root are diuretic, 
alterative, and anodyne, and in some places are used in liver com- 
plaints, scrofula, dropsy, and diseases of the skin. Applied externally 
in the form of ointment, or fomentation, it is said to be useful in piles, 
painful tumors, bruises, ringworm, and inflammation of the breasts. 
Dose of the infusion, from two to four fluid ounces, three times a day. 

Flaxseed {Linum Usitaiissimum). — This is demulcent and nutri- 
tive, and is much used in coughs, bronchial diseases, inflammation of 
the urinary organs, bowels, and lungs; chiefly taken in the form of 
flaxseed tea. The infusion is sometimes used as an injection in dys- 
entery and piles. Linseed oil is prepared from flaxseed. 



Fig. 203. 



FiQ. 204. 





FOXGLOVE. 



Foxglove (Digitalis Purpurea). — A biennial plant, growing in the 
temperate parts of Europe. The leaves, in proper doses, are sedative 
and diuretic, reducing the pulse, and increasing the flow of urine. In 
large doses, they are a narcotic poison. The medicine has been much 
used in inflammatory diseases, palpitation of the heart, and in droi)sy 
connected with diseased heart or kidneys. When taken for some 
time, it is liable to accumulate in the system, and suddenly to mani- 
fest poisonous and alarming symptoms, as if a large dose had been 
taken. The American hellebore is fast supplanting it as a remedy. 
Dose of the powdered leaves of foxglove, from one to three grains ; 
of the tincture, from eight to twelve drops. 

Frostweed (Helianthemum Canadense). — This herb, also known by 
the name of rockrose, is tonic, astringent, and alterative, and has been 
considerably used in scrofula; combined with turkey corn, and queen's 
root, it is said to have eflected cures in secondary syphilis. A decoc- 
tion forms a useful gargle in ulcerations of the mouth and throat in 



MEDICINES AND THEIR PREPARATIONS. Ci3 

scarlet fever, and other diseases, and as a wash in scrofulous inflam- 
mation of the eyes. Dose of the fluid extract, one to two drams, 
three or four times a day. 

Galls. — These are the unhealthy excrescences found growing on 
the young boughs of the dyer's oak, quercus infectoria, growing in 
Asia. They are powerfully astringent. In the form of infusion, or 
decoction, made in the proportion of half an ounce to a pint of water, 
they are useful as an astringent gargle, wash, or injection ; and finely 
powdered galls, one part to eight parts of lard, make a valuable oint- 
ment for bleeding piles. Dose of powdered galls, from ten to twenty 
grains. 

GiUiibo2,'e. — The hardened juice of trees growing in Siam and 
Cochin C.hina. This gum-resin is a hydragogue cathartic, acting 
severely and harshly upon the bowels, and hence is not often used 
alone. On account of the severity of its action, it is improper to use 
it during inflammation of the stomach or bowels, piles, pregnancy, 
diseased womb, or excessive menstruation. Combined with cream of 
tartar and jalap, it is a valuable remedy in dropsy. The dose is one 
or two grains. 

Garlic (Allium Sativum). — The bulb is the part used. It is stimu- 
lant, diuretic, expectorant, and rubefacient ; useful in coughs, hoarse- 
ness, hooping-cough, and in the nervous spasmodic coughs of children. 
Dose, from twenty grains to three drams; dose of the juice, mixed 
with sugar, half a teaspoonful to a teaspoonful. 

The bruised bulbs are sometimes usefully applied as a poultice 
to the chests of young children having inflammation of the lungs, 
and as drafts to the feet in inflammation of the brain, fevers, etc. 

Gentian [Gentiana Lutea). — It grows among the Alps, Apennines, 
and Pyrenees. The root is the part used, and is brought to this coun- 
try from Germany. This medicine has long maintained its reputa- 
tion, having, it is said, derived its name from Gentius, king of lUyria. 
It is a pure and simple bitter, exciting the appetite, and invigorating 
the digestive powers. It may be used in all cases dependent on pure 
debility. It is much employed in dyspepsia, and during recovery 
from exhausting diseases. 

Preparations, — Fluid extract, dose, half a dram to a dram ; com- 
pound fluid extract, dose, half a dram to a dram ; solid extract, dose, 
three to fifteen grains ; tincture, four ounces to one pint of diluted 
alcohol, dose, two to five drams. A valuable preparation is made, by 
uniting fluid extract of rhubarb, two ounces ; fluid extract of gentian, 
half an ounce ; diluted alcohol, two pints ; dose, half an ounce to two 
ounces. 

Ging'er [Zingiber Officinale). — This is a native of Hindostan, and 
is cultivated in all parts of India. The root is the part used. It is a 
grateful stimulant and carminative, and is much used for dyspepsia, 
wind in the stomach, colic, gout, etc. It is an excellent addition to 
bitter infusions, and is much used to disguise the taste of nauseous 
medicines. Dose, from ten to thirty grains. 



G14 



MEDICDJES AXD THEIR PREPARATIONS. 



Preparations. — Fluid extract, dose, half a dram to a dram ; tincture, 
four ounces to one pint of diluted alcohol, dose, two to four drams ; 
infusion, dose, one to two ounces ; syrup, dose, one to two drams. 

Ginseng; (Panax Quinquifolium). — A perennial plant, growing in 
the Middle and Southern States. It is a mild tonic and stimulant, 
and has some reputation for improving impaired appetite, and for 
nervous debility, weak stomach, etc. Some persons are in the habit 
of chewing it, and it is considerably used in this way. Dose of the 
powdered root, from ten to sixty grains ; of the infusion, from two to 
four fluid ounces. 

Glycerin. — This is the sweet or sugary portion of oils, and is ob- 
tained from them during the manufacture of lead plaster. It is demul- 
cent and antiseptic, and has been recently recommended and used, to 
some extent, in place of cod liver oil, in consumption. It has been 
still more used, however, as a soothing and emolient external applica- 
tion in skin diseases, and also in place of lard in the preparation of 
ointments. 

Gold. — The chief sort of gold used in medicine, is the chloride or 
muriate of gold and soda. It is diuretic and alterative. It is used 
in scrofula, skin diseases, goitre, scirrhous tumors, opthalmia, dropsy, 
and syphilis. The dose is from one thirtieth to one twelfth of a grain, 
and is given dissolved in water, or made into pill with starch or gum 
arable. 

Golden Seal (Hydrastis Canadensis). — A perennial plant, growing 
throughout the United States, particularly in the West. The root is 
the medicinal part. It is a tonic, having 
especial action upon diseased mucous tis- 
sues, and is particularly beneficial during 
recovery from exhausting diseases. It is 
used in dyspepsia, chronic affections of the 
nervous coats of the stomach, erysipelas, 
and remittent, intermittent, and typhoid 
fevers. United with geranium, it has a fine 
efiect in chronic diarrhoea and dysentery. 

Preparations. — Fluid extract, dose, half a 
dram to two drams ; solid extract, dose, two 
to five grains ; hydrastin (resinoid), dose, one 
half to five grains ; hydrastin (neutral), dose, 
two to six grains ; hydrastina (alkaloid), 
dose, one to five grains ; tincture, dose, three 
ounces to one pint of diluted alcohol, dose, 
half an ounce to an ounce and a half. For 
various forms of sore mouth and ulcerated 
sore throat, the following is a useful gargle : 
fluid extract of golden seal, half an ounce; 
fluid extract of bUae cohosh, half an ounce ; 
fluid extract of witch-hazel, half an ounce; pulverized alum, one dram; 
honey, three drams ; water, one pint. As a stimulant for a sluggish 



Fig. 205. 




GOLDEN SEAL. 



JklEDICINES AND THEIR PREPARATIONS. 615 

liver, and as a tonic in enfeebled mucous membrane in epidemic dys- 
entery, and other complaints, the following powders are valuable : 
hydrastin, twenty grains; leptandrin, twelve grains; podophyllin, two 
grains; pulverized cayenne, two grains; sugar of milk, or pulverized 
loaf sugar, one dram ; rubbed together thoroughly in a mortar, and 
divide into twenty powders ; give one every two hours. 

Ground Ivy (Nepeta Glechoma). — A perennial herb, common to 
the United States and Europe ; in some places known as gill-over- 
the-ground. The leaves are the part used, which are stimulant, tonic, 
and pectoral ; considered useful in jaundice, asthma, and diseases of 
the kidneys and lungs. 

Guaiaciun. — This medicine is the shavings or chips of the wood of 
a tree growing in the West Indies, also resin obtained from the same 
tree. It is stimulant and alterative, and is used in chronic rheuma- 
tism, diseases of the skin, scrofula, and venereal complaints. The 
tincture of the resin is valuable as an emmenagogue. Dose of the 
tincture, from one-half to two teaspoonfuls, to be taken with milk. 
The wood is much used as an ingredient in alterative preparations of 
sarsaparilla, etc. 

Gum Arabic. — This is the hardened juice of trees growing in 
Egypt, Arabia, and other tropical countries, being several varieties 
of the acacia. It is demulcent, and a combustive nutritive, and is 
much used in forming mixtures for hoarseness, cough, sore throat, 
gonorrhoea, inflammation of the bladder, strangury, bronchitis, and 
irritations of mucous membranes generally. Mucilage of gum arable 
is a preparation made by dissolving four ounces of powdered gum in 
a pint of boiling water. 

Gum Hemlock. — This is the hardened juice of the hemlock, Abies 
Canadensis^ a tree growing in Canada and Maine. This gum is a 
mild rubefacient, and like burgundy pitch, chiefly used to make plas- 
ters, etc., for which purpose it is very valuable. A tincture of the gum 
is diuretic and stimulant. The oil of hemlock is valuable, in combi- 
nation with other oils, in preparing liniments. The bark is astringent, 
and is much used in tanning leather. 

Hsemastasis. — This word is used to imply the retention of the 
venous blood in the limbs by ligatures. A cord or common handker- 
chief, is tied round the upper part of the arms, or thighs, and a piece 
of wood being slipped under the cord, is twisted round until the cord 
is so tightened as to prevent the return of the venous blood, but not 
to prevent the outward passage of the arterial blood. In this way, 
the blood passing out continually in the arteries, and not returning 
by the veins, the vessels of the limbs become filled to their utmost 
capacity, and a great quantity, for the time being, is w^ithdrawn from 
the trunk, — greater than any surgeon would dare to remove with the 
lancet. This process is useful in bleedings from the lungs, stomach, 
and womb, and inflammation of the brain, lungs, bowels, etc., and 
in whatever case it may be thought desirable, for the time being, 



616 MEDICINES AND THEIR PREPARATIONS. 

to lessen the blood in the head or trunk, without debilitating the 
patient. 

Ilair-cap Moss (Pohjtrichum Jvnipervm). — An evergreen plant grow- 
ing on poor sandy soils in the Northern States. A strong infusion of 
it is powerfully diuretic. In dropsical cases, two fluid ounces of the 
infusion should be taken every half hour. It is useful in fevers, in- 
flammations, gravel, etc. 

Hardliack {Spiroea Tomentosa): — This is a beautiful shrub, com- 
mon in the United States. Its leaves are of a dark green color above, 
and white underneath. It is tonic and astringent, and is 
much used in chronic diarrhoea, cholera infantum, etc. It ^^^- ^^- 
agrees well with the stomach, and is deservedly a popular 
remedy in summer complaints of children. 

A fluid extract of it is prepared by Tilden &• Co. ; dose, 
four to twenty drops. It is much used in the form of infu- 
sion. The green herb boiled in milk forms a valuable pre- 
paration in chronic diarrhoea, when attended with much 
debility. 

Hiinlleaf Golden-Rod (Solldago Rigida). — A perennial 
plant, growing throughout the United States, especially on 
the western prairies. It is tonic, astringent, and styptic, and 
useful to arrest bleeding from the nose, lungs, stomach, and 
bowels. The powder and infusion are used, both externaUy 
and internally. . haedhack. 

Heloiiias {Helonias Dioica). — This herb is common in the United 
States, and is known by the name of False Unicorn plant. The root, 
which is the part used, is tonic, diuretic, and vermifuge. In large 
doses, it is emetic, and when used fresh, sialagogue. In five or ten 
grain doses, three times a day, it relieves dyspepsia, restores the appe- 
tite, expels worms, and relieves colic. It is a valuable womb tonic, 
gradually removing debility of that organ, and curing whites, pain- 
ful menstruation, and a tendency to habitual abortion. Dose of the 
decoction, from two to four fluid ounces. The decoction is said to 
kill insects, bugs, etc. 

Preparations. — P'luid extract, dose, one to three drams ; helonin, 
the active principle, dose half a grain to a grain. 

Henbane (Hyoscyamus Niger). — This plant grows abundantly in 
Great Britain, and on the continent of Europe, and is rare in this 
country. All the parts are active. It is narcotic, gently accelerating 
the circulation, increasing the general warmth, occasioning a sense of 
heat in the throat, and after a time inducing sleep. It is often used 
in the place of opium, because it does not bind the bov/els. Used in 
rheumatism, gout, bronchitis, asthma, consumption, hooping-cough, 
hysterics, and spasmodic affections generally. 

Preparations. — Fluid extract, dose, ten to twenty drops ; solid ex- 
tract, dose, half a grain to a grain ; tincture, two ounces to one pint 
of diluted alcohol, dose, half a dram to a dram and a half ; hyoscya- 




MEDICINES AND THEIR PREPARATIONS. 



617 



mill, the active principle, dose, one eighth to half a grain. In neural- 
gia, rheumatism, St. Vitus's dance, painful menstruation, etc., the 
following may be found useful : solid extract of hyoscyancius, two 
drams ; solid extract of valerian, two drams ; solid extract of aconite, 
one dram ; sulphate of quinia, one dram. Mix, and divide into two 
grain pills ; one pill every two or three hours. 

Ilio'li Cranberry ( Viburnum Opulus). — This shrub grows in rich 
soils in Canada, and in the northern United States. The bark, which 
is the medicinal part, is antispasmodic, being used in cramps, spasms, 
asthma, hysterics, and is useful for those who are subject to convul- 
sions during pregnancy, and at the time of childbirth. It is popularly 
known by the name of Cramp Bark. A decoction or infusion of the 
bark, {nay be used in tablespoonful doses, two or three times a day. 
Dose of the extract, from one to five grains; in womb troubles, it 
may be united with caulophyllin, cimicifugin, aletridin, senecin, and 
asclepidin ; and in flatulent colic, spasmodic pains of the stomach 
and bowels, it may be combined with dioscorein. 



Fio. 207. 



FiQ. 208. 





HOREHOUND. 



Horelioiind {Marnbium Vnlgare). — This well known perennial herb 
is a native of Europe, and has become naturalized in this country. 
It is tonic, aperient, pectoral, and sudorific. It is deservedly popular 
in domestic practice, for colds, asthma, throat-ails, bronchitis, and other 
pectoral affections, attended with cough. It is much used in candy. 

Preparations. — Fluid extract, dose, half a dram to one dram ; solid 
extract, dose, five to ten grains ; tincture, two ounces to one pint of 
alcohol, dose, half an ounce to an ounce ; syrup, three ounces fluid 
extract to one pint of simple syrup, dose, three to six drams. 

Hops {Humulus Lupulus). — The cones of this well-known plant 
are tonic, hypnotic, antilithic, and anthelmintic. They are chiefly 
used for promoting sleep, and relieving pain and irritability of the 
nervous system. Hops are valuable in the form of fomentation, either 

leset, and other bitter herbs. An 

78 



alone, or in combination with boneset, and other bitter herbs 



G18 MEDICINES AND THEIR PREPARATIONS. 

ointment of hops and stramonium leaves is sometimes used in salt- 
rheum, and upon painful tumors and ulcers. A pillow stuffed with 
hops, dipped in hot water, and placed under the head of the patient, 
relieves pain and procures sleep. 

Lupulin is the yellow powder obtained by threshing the hops, and 
is preferable to the hop itself. It is a powerful antaphrodisiac, com- 
posing the genital organs, and quieting painful erections, in gonor- 
rhoea, etc. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, five to twenty grains ; tincture, two and half ounces to 
one pint of alcohol, dose, three to six drams ; infusion, four drams to 
one pint of water, dose, two to four ounces ; lupulin, dose, six to ten 
grains; tincture of lupulin, two ounces to one pint of alcohol, dose, one 
to two drams, in sweetened water ; fifteen to twenty grains of lupulin, 
well rubbed up with white sugar in a mortar, is very efficacious in 
priapism, chordee,-and spermatorrhoea. 

Ilorsemiiit (Monarda Punctata). — This well-known plant, which is 
common to the United States, is stimulant, carminative, and diuretic. 
A warm infusion may be used in flatulence, nausea, and vomiting. 
If the body be kept cool while taking it, it will act as a diuretic. The 
oil of horsemint, is used for similar purposes with the plant. Dose, 
from two to six drops on sugar. Dose of the essence, from ten to 
forty drops in sweetened water. The oil is frequently used as an in- 
gredient in liniments. 

Horseradish ( Cochlearia Armoracia). — The fresh root of this well 
known perennial is stimulant, diuretic, antiscorbutic, and rubefacient. 
It is useful in rheumatic, paralytic, scorbutic, dropsical, and dyspeptic 
affections. It is said that a warm infusion of the fresh root in cider, 
drank freely every night, will cause perspiration, and a free flow of 
urine, and will consequently cure dropsy. The fresh root grated in 
vinegar, and eaten with meat at dinner, strengthens the stomach, and 
promotes digestion. 

Ilouseleek (Sempervivum^ Tectorum). — The bruised leaves of this 
perennial, form a cooling application to burns, stings of insects, ery- 
sipelas, and other inflammations; valuable also for ringworm, shingles, 
and other skin diseases. 

Hydrangea {Hydrangea Arborescens). — This grows abundantly in 
the Southern, Middle, and Western States. Its root is medicinal. It 
is diuretic, and has been much praised for its power of relieving the 
excruciating pain, caused by the passage of stone through the urethra, 
as well as for infallibly removing such stones from the bladder, pro- 
vided they are not already too large for passage through the water 
pipe. As many as one hundred and twenty calculi have been known 
to pass off from one person, under the use of this remedy. A con- 
centrated decoction, or the fluid extract prepared by Tilden & Co., 
may be taken in teaspoonful doses several times a day, — care being 
taken not to push the medicine to the extent of dizziness, or oppres- 
sion of the chest. 



:mkdicixes and their preparations. 6.19 



Ifyssop (Hijssopus Officinalis). — This is a native of the continent 
of Europe, and is cultivated in this country. The tops and leaves are 
the parts used. They are stimulant, aromatic, carminative, and tonic. 
The infusion has been much employed in chronic bronchitis of old 
people, and those of debilitated habits. It makes the raising of mucus 
more easy. The infusion may be combined with sage and alum, and 
sweetened with honey. The fresh leaves bruised, and applied exter- 
nally, relieve the pain, and disperse the spots and marks caused by 
contusions. 

Icelnud Moss (Cetraria Islandica). — This plant is found in tho 
northern latitudes, both of the old and new world, and is abundant 
on the mountains, and in the sandy plains of New England, It re- 
ceived its name from its prevalence in Iceland, in which country, as 
well as in Lapland, it serves, in consequence of the gum and starch 
it contains, as food for the inhabitants. It is demulcent, tonic, and 
nutritious, and is well fitted to relieve affections of the mucous mem- 
brane of the lungs and bowels, connected with debility of the digestive 
organs; it is given therefore in chronic bronchitis, and other affections 
of the chest, attended with copious expectoration, especially when 
the matter discharged is purulent ; also in dyspepsia, chronic dys- 
entery, and diarrhoea. It is usually employed in the form of decoc- 
tion ; and is much used in the common article of diet, called blanc 
mange. 

Ice Plant (Monotropa Utiiftora). — This perennial plant, found in 
various parts of the country, is snow white, resembling frozen jelly, 
and is juicy and tender, dissolving in the hands like ice. The flowers 
are in shape like a pipe ; it is hence called the pipe plant. The root 
is the medicinal part, and is tonic, nervine, and antispasmodic. It 
has also been considered sedative and diaphoretic ; and the powder 
has been sometimes used in the place of opium. It is said to be 
valuable in epilepsy, chorea, and other spasmodic afTections. Dose 
of the powdered root, from thirty to sixty grains, two to three times 
a day. 

Indian Hemp (Apocynum Cannabinum). — This perennial plant re- 
sembles bitter-root, and grows in similar situations. The root is 
powerfully emetic, and in decoction, diuretic, and diaphoretic. It 
diminishes the frequency of the pulse, and produces drowsiness. It 
has great efficacy in dropsy. 

Preparations. — Fluid extract, dose, as a tonic, five to fifteen drops, 
as an emetic, twenty to sixty drops ; solid extract, dose, one to five 
grains ; tincture, dose, one to two drams, as a tonic, half an ounce to 
an ounce, as an emetic; infusion, half an ounce to a pint of water, 
dose, half an ounce to two ounces. 

Indian Turnip {Arum Triphyllum). — This is a perennial plant, 
growing in damp places in North and South America, and known by 
the name of dragon root. The root when chewed, is excessively acrid, 
producing a biting sensation which may be somewhat relieved by 



620 MEDICINES AND THEIR PREPARATIONS. 

milk. The fresh root is acrid, expectorant, and diaphoretic, and has 
been used in asthma, hooping-cough, chronic bronchitis, chronic rheu- 
matism, and colic, and externally, in scrofulous tumors, scald head, 
and other skin disorders. Dose of the grated root, in syrup or mucil- 
age, ten grains, three or four times a day. 

Iodine {lodinvm). — This is prepared from the ashes of kelp, or sea- 
weed, and is in small bluish-black, shining scales. It is alterative, 
tonic, and somewhat diuretic. It has been chiefly employed in dis- 
eases of the absorbent and glandular system, particularly scrofula, 
goitre, and glandular tumors generally. Dose, in substance, half a 
grain, two or three times a day, in form of pill ; in form of tincture, 
five to ten drops. 

Iodide of Potassium (Poiassii lodidum). — This is one of the pre- 
parations of iodine, and is sometimes improperly called hydriodate of 
potassa. It is formed by decomposing the iodide of iron, by carbon- 
ate of potassa. It is used for the same purposes as iodine, but chiefly 
as an alterative in tertiary syphilis, for which it is a specific ; also in 
some forms of chronic rheumatism, and in leprosy. Dose of the salt, 
from two to twenty grains. It is much combined with bitter tinc- 
tures, and particularly with the compound preparations of sarsapa- 
rilla, yellow dock, and queen's root. The acids and metallic salts are 
incompatible with it. 

Ipecacuanha. — This is a small perennial plant, growing in moist 
woods, in several countries of South America. The root is the part 
used. It is a very valuable emetic, in large doses ; in smaller doses, 
it is sudorific and expectorant. Used to produce vomiting in the 
commencement of fevers, inflammatory diseases, swelled testicles, and 
before the paroxysms of ague ; and to excite nausea in dysentery, 
asthma, hooping-cough, various hemorrhages, and inflammation of 
the lungs ; and, combined with opium, to produce diaphoresis in rheu- 
matism, gout, and febrile complaints. Dose, as an emetic, from fifteen 
to thirty grains ; to excite nausea, from one to three grains ; and to 
produce diaphoresis, two to six grains, with one grain of opium. 

Preparations. — Fluid extract, dose, as an expectorant, five to ten 
drops ; as an emetic, half a dram to a dram ; tincture, half an ounce 
to an ounce and a half; wine of ipecac, three ounces to one pint of 
sherry wine, dose, a quarter to half a dram, as an expectorant ; two 
and a half to five drams as an emetic. The following is a useful ex- 
pectorant for young children : fluid extract of ipecac, two drams ; 
syrup of tolu, five drams ; mucilage of gum arable, one ounce ; sherry 
w^ne, three drams, — mix. Dose, one dram. 

Iron (Ferrum). — As this is the most abundant, so it is the most 
useful of all the metals. It is widely diffused through the mineral, 
Ihe vegetable, and the animal kingdoms. It is an essential constitu- 
ent in the blood of man, and as a medicine it has great value, being 
a powerful tonic. In most cases where the blood is thin and reduced, 
iron is our best remedy ; it raises the pulse, promotes the secretions, 
and gives color, body, and nutritive qualities to the blood. It is much 



MEDICINES AXD THEIR PREPARATIONS. 621 

used, in some one of its prepared forms, in chronic anaemia, chlorosis, 
hysterics, whites, rickets, chorea, dyspepsia, neuralgia, and particularly 
consumption. The following are most of the chemical preparations 
of iron used in medicine. 

Amniouio-Citnite of Iron {Ferri Amvionio-Citras). — This is in the 
form of thin scales, of a beautiful, garnet-red color, and has a slightly 
acid taste. It is very soluble in water. Its great solubility gives it 
some advantages over the citrate. The dose is five grains, three times 
a day, in solution. 

Black Oxide of Iron (Ferri Oxidimi Nigrum). — This is a dark, 
grayish-black powder, unchangeable in the air, and having magnetic 
properties. It is a valuable chalybeate, and may be given in five to 
fifteen-grain doses. 

Citrate of Iron (Ferri Citras). — This is a valuable preparation of 
iron. It is soluble in water. Usually given in the form of pill, in 
two to five grain doses, three times a day. 

Citrate of Iron and <)ninia (Ferri et Quince Citras). — In the form 
of shining scales, garnet-colored, and soluble in water. An excellent 
antiperiodic and tonic. Given in intermittents, when the blood is low, 
etc. Dose, five to ten grains, two or three times a day. 

Citrate of Iron and Stryclinia. — Dr. James R. Nichols & Co., of 
this city, were the first to introduce this combination of strychnia 
with iron, to American physicians. It is a valuable preparation, and 
is constantly winning the favor of the profession. It combines the 
properties of iron and strychnia, and has proved an efficacious remedy 
in atonic dyspepsia, absence of tlie menses, St. Vitus's dance, green- 
sickness, hysterics, etc. It is a beautiful salt, looking like citrate of 
iron, except that it is a little darker. Three grains of the iron are com- 
bined with one sixteenth of a grain of strychnia. 

Hydra ted Oxide of Iron (Ferri Oxidum Hydratum). — This is in 
a reddish-brown, moist mass, not much used in medicine, except as 
an antidote to the poison of arsenic, for which it is very valuable. It 
should be given in tablespoonful doses, often repeated. 

Iodide of Iron (Ferri lodidum). — The iodide of iron is a crystalline 
substance, of a greenish-black color, and styptic taste. It has tonic, 
alterative, diuretic, and emmenagogae properties. It is employed 
chiefly in scrofulous complaints, swelling of the glands of the neck, 
chlorosis, absence of the menses, and leucorrhoea. In obstinate syph- 
ilitic ulcers, and in secondary syphilis, occurring in scrofulous and 
debilitated subjects, it has been used with success. Dose, three grains, 
gradually increased to eight. It should never be given in the form 
of pill. 

Lactate of Iron (Ferri Lactas). — This has the general medicinal 
properties of the ferruginous preparations. It increases the appetite 
in a marked degree, and has been used with decided benefit in chlo- 
rosis. Dose, one to three grains, three times a day. The dose may 
be gradually increased. Given in the form of solution, pill, or lozenge. 



622 MEDICINES AND THEIR PRErARATIOXS. 

Phosphate of Iron (Ferri Phosphas). — This is a slate-colored pow- 
der, insoluble in water. It is a valuable remedy in consumption, 
cancer, and nervous diseases, accompanied by a low state of the 
blood. Dose, one or two grains, three times a day. 

Per Salt of Iron {MonseVs Styptic). — This is a most valuable styp- 
tic, and is used with success in restraining violent bleedings. It pro- 
duces no irritant effects upon the tissues, and may be used with safety 
both in slight and extensive surgical operations. Physicians should 
have it by them, and will find it very serviceable in sudden emergen- 
cies of bleeding. It is prepared in solution and in the form of dry 
salt, by Dr. James R. Nichols & Co., of this city. The solution is the 
most convenient and eligible form, and may be applied as prepared. 

Powder of Iron (Ferri Pulvis). — This is what is often called iron 
by hydrogen, or Quevenne's iron. It is an impalpaple powder, and of 
an iron-gray color. If black, it is worthless. It is used in anaemia, 
and in all those conditions characterized by deficiency of coloring 
matter in the blood. The best metallic iron for medicinal use. Dose, 
from two to six grains, several times a day ; to be given in the form 
of pill. 

Precipitated Carbonate of Iron (Ferri Suhcarhonas). — This is a 
reddish powder, insoluble in water. It is tonic, alterative, and em- 
menagogue, and is used in neuralgia, chorea, chlorosis, anemia, epi- 
lepsy, scrofula, etc. Dose, five to thirty grains, three times a day, to 
be taken in a little water. 

Protoxide of Iron (Ferri Frotoxidum). — This is of a dark blue 
color, and has a tendency to absorb oxygen from the air, which con- 
verts it into the sesquioxide. It is a valuable preparation of iron. 
Dose, from two to six grains, three times a day. 

Sohition of Protoxide of Iron. — The protoxide of iron being more 
readily absorbed and assimilated, and agreeing better with the stom- 
ach, than any other preparation of this metal, has led to a general desire 
for this salt in some eligible form, protected from the chemical changes 
to which it is so liable. This desire has been met by Dr. James R. 
Nichols & Co. of this city, who, by a new method of chemical ma- 
nipulation, have prepared an unchangeable solution of it, in the form 
of an elegant syrup, which is permanent in form, pleasant to the taste, 
and free from the inky flavor peculiar to iron preparations. Dr. Nich- 
ols, one of the most reliable practical chemists in the country, has 
conferred a benefit upon the profession by preparing this syrup. I 
have had the pleasure of using it, with peculiar satisfaction. Dose, 
from one to two teaspoonfuls, three times a day. 

Sohition Protoxide Iron, with Rhubarb and Colunibo. — This is a 
composition of protoxide of iron with vegetable tonics; a combina- 
tion long desired, but just now, for the first time effected, by Dr. 
James R. Nichols & Co. of this city. As a remedy in many forms 
of dyspepsia, it must prove of great value. 

Sohition Protoxide Iron, with (luiniue. — This has become a remedy 



MEDICINES AND THEIR PREPARATIONS. 623 

of established reputation. Quinine combined with iron, particularly 
with the protoxide, must have great advantages as a chalybeate tonic. 
This is one of the reliable preparations of Dr. Nichols. Each table- 
spoonful contains half a grain of quinine. 

Solution Protoxide Iron, with Iodide of Potassa. — In this prepara- 
tion, the valuable alterative properties of iodide of potassium, are 
connected with iron. It is therefore alterative and tonic, and may be 
used in scrofulous and other weakened conditions of the system. It 
is a remedy of decided merit. Three grains of the iodide of potas- 
sium are contained in each tablespoonful. This is also prepared by 
Dr. James R. Nichols & Co. 

Sulphate of Iron (Ferri Sulphas). — This is in the form of transpa- 
rent crystals, of a pale, bluish-green color, and efflorescent in the air. 
It has a styptic taste, and is soluble in about twice its weight of 
cold water, but insoluble in alcohol. It is astringent and tonic. In 
large doses, it produces nausea and griping of the bowels. Useful in 
scrofula, and as an astringent, in passive hemorrhages, sweats, dia- 
betes, chronic mucous catarrh, leucorrhoea, and gleet. As a tonic, it 
is useful in dyspepsia. 

Syrup of Iodide of Iron (St/rupiis lodidi Ferri). — This is an ele- 
gant preparation of iodine and iron, and is given in all debilitated 
conditions of the system, when there is a taint of scrofula. Dose, 
from twenty to fifty drops, well diluted, at the moment of taking, with 
water. 

Synip of Iodide Iron and Mano-anese. — This is of a light straw 
color, prepared from protosulphate of iron, protosulphate of manga- 
nese, and iodide of potassium. It is a remedy of unsurpassed effi- 
cacy in janasmic, scrofulous, syphilitic, and cancerous affections. It 
is considkred superior to the syrup of iodide of iron. This is another 
of Dr. J. R. Nichols & Co.'s valuable preparations. Dose, from ten 
to sixty drops. 

Tarti'ate of Iron and Potassa {Ferri et Potassce Tartras). — This is in 
the form of beautiful shining scales, of a dark ruby color, of a slightly 
chalybeate taste, and very soluble in water. It is one of the mild- 
est of the salts of iron, and is considerably used in scrofula, weak- 
ness of the bowels, general debility, etc. It is much used of late, as 
a remedy for syphilis, both externally and internally. The dose is 
ten to thirty grains in solution. 

Tincture of Mliriate of Iron {Tinctura Ferri Chloridi). — This has 
a reddish-brown, yellowish color, a sour and very styptic taste, and an 
odor like muriatic ether. It is one of the most active and certain pre- 
parations of iron, generally agreeing with the stomach, and much 
employed for purposes for which iron is used. It is useful in scrofula, 
gleet, and leucorrhcsa ; also in hemorrhages from the womb, kidneys, 
and bladder, of a passive character. Dose, from ten to thirty drops, 
gradually increased to one or two drams, two or three times a day. 
It should be given diluted with water. 



624 ' MEDICINES AND THEIR PREPARATIONS. 

Valerianate of Iron. — This salt is in the form of a dark-red pow- 
der, having a faint odor, and a taste of valerianic acid. It is soluble 
in alcohol, and insoluble in water. Given in hysterical affections, 
complicated with chlorosis. Dose, one grain, several times a day. 

Ising'lass (Ichthyocolla). — A gelatinous substance, prepared from 
the bladder of fishes. It is soluble in alkaline solutions, and diluted 
acids. In boiling, it dissolves, and forms a jelly upon cooling, in which 
form it is chiefly used as a nutritive diet for the sick. 

Jalap {Ipomoea Jalapa). — This is a Mexican plant. Its root is an 
active cathartic, producing liquid stools, more or less griping. United 
with cream of tartar, it becomes a hydragogue, and is useful in dropsy. 
The dose is from fifteen to thirty grains. 

Preparations. — Fluid extract, dose, a quarter to one dram ; solid 
extract, dose, three to eight grains ; tincture, two ounces to the pint 
diluted alcohol, dose, one to two and a half drams ; jalapin, the active 
principle, dose, one to two grains. 

Juniper {Juniperis Communis). — This evergreen shrub is a native 
of Europe, and is naturalized in some parts of this country. The 
berries, which are the part used, are wrinkled, of a dark-purple color, 
about the size of a pea. They are gently stimulant and diuretic, and 
have been used in scurvy, and inflammation of the bladder, chiefly in 
connection with more active diuretics. The oil of juniper obtained 
from the berries is used for similar purposes. Five minims of the oil, 
mixed with one fluid dram of sweet spirits of nitre, and given three 
times a day, is valuable in dropsy. Dose of the berries, from one to 
two drams ; of the oil, from five to fifteen drops. 

Kino. — This is the hardened juice of an East Indian tree, Ptero- 
carpus Marsupinm. There are several varieties of it. It is a power- 
ful and valuable astringent, and is much used in diarrhoea, not atten- 
ded with inflammation. Opium is often united with it, and it is a 
favorite addition to chalk mixture. It is also used in chronic dysen- 
tery, leucorrhcea and diabetes. It may be used in the form of powder, 
infusion, or tincture. Dose of the powder, ten to thirty grains ; of the 
tincture, one or two fluid drams ; the infusion is useful as an injection, 
in leucorrhcea and gonorrhoea. The powder is sometimes sprinkled 
with advantage on indolent and flabby ulcers. 

Ladies' Slipper ( Cypripedium Pubescens). — The fibrous roots are 
the parts used of this plant. It is tonic, nervine, an4 antispasmodic, 
and is employed in nervous headache, and other nervous affections, as 
excitability, hysterics, neuralgia, etc. 

Preparations. — Fluid extract, dose, half a dram to a dram; solid 
extract, dose, five to fifteen grains ; tincture, two ounces to a pint of 
diluted alcohol, dose, half an ounce to an ounce ; cypripedin, the 
active principle, dose, two to four grains. The following is a useful 
preparation for producing sleep, in wakeful and excited conditions : 
fluid extract ladies' slipper, one ounce ; fluid extract pleurisy root, 
one ounce ; fluid extract skunk cabbage, one ounce ; fluid extract 



MEDICINES AND THEIR PREPARATIONS. 625 

scullcap, one ounce ; mix ; dose, half a dram to a dram, three times a 
day. 

For sick and nervous headache, dependent on an acid stomach, the 
following is useful : fluid extract ladies' slipper, half an ounce ; fluid 
extract catnip, half an ounce ; fluid extract scullcap, half an ounce ; 
water, one pint ; mix ; dose, one and a half to three drams. 

Lead {Plumbum). — Lead acts upon the system as a sedative and 
astringent. Internally, it is used for the purpose of reducing the force 
of the circulation, and for restraining improper bleeding, and other 
excessive discharges. Externally, it is employed to subdue inflamma- 
tion. It should not be excessively used ; for, if taken internally for a 
long time, it injures the nervous system, and brings on apoplexy, 
palsy, and particularly lead colic. Nature generally gives notice when 
it is doing mischief, by drawing a blue line around the ed^e of the gum. 
The preparation of lead chiefly used in medicine is the following: 

Acetate of Lead (Plumbi Acetas). — This is known by the name 
of sugar of lead, and is a white salt, crystallized in brilliant needles. 
It has first a sweetish, and then an astringent taste. In medicinal 
doses, it is a powerful sedative and astringent; in large ones, an irri- 
tant poison. It is principally used, internally, for bleeding from the 
lungs, bowels, and womb. The dose is generally two grains, united 
to half a grain to a grain of opium, in the form of pill. Externally, 
it is employed in form of solution, and applied to inflamed surfaces 
with cloths. Four grains of sugar of lead, and four of pulverized 
opium to the pint of water, makes a good lotion for various purposes. 

Lemon ( Citrus Limonum). — This is a well-known tropical fruit, 
the juice of which has a grateful acid taste, which is much used in 
fevers and inflammatory complaints, to form the agreeable drink 
called lemonade. The oil of lemon, obtained from the fresh rind 
of the fruit, is chiefly used in perfumery, and to render the taste of 
medicines more agreeable. 

Lettiiee (Lactuca Sativa). — The medicinal properties of this gar- 
den plant are contained in the milk. It is given when opium disa- 
grees with the patient, to allay cough and irritability. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
solid extract, dose, two to five grains. The following is a useful com- 
pound syrup : fluid extract lettuce, two ounces ; fluid extract poppy, 
four ounces ; simple syrup, ten ounces ; mix ; dose, half a dram to a 
dram. 

Life Root (Senecio Aureus). — This is a perennial plant, growing 
on the banks of marshy creeks, in the Northern and Western States, 
and sometimes called Ragwort. Both the root and herb are diuretic, 
pectoral, diaphoretic, and tonic, considerably valued as a remedy in 
gravel, and other urinary affections, particularly strangury. It is use- 
ful for promoting menstrual discharges. 

Preparations. — Fluid extract, dose, half a dram to a dram ; infu- 
sion, dose, one to four ounces ; senecin, the active principle, dose, 

79 



626 MEDICIXES AND THEIR PREPARATIONS. 

three to five grains. For chlorosis, accompanied by absence of the 
menses, the following is a useful preparation : senecin, aletrin, and 
sulphate of iron, four grains each. Mix, and divide into two grain 
powders. Six grains each of senecin and geraniin, mixed, and taken 
in doses of two to four grains, has a good effect in restraining an 
immoderate flow of the menses. In painful menstruation the follow- 
ing is a good pill : senecin, two grains ; quinine, six grains ; solid 
extract belladonna, three grains ; make into ten pills, and take one 
every three hours, till the pain is subdued. 

Lime (Calx). — This is one of the alkaline earths, and is an abun- 
dant natural production. It is used in several forms in medicine, of 
which the following are the chief. 

Chloride of Lime ( Calx Chlorinata). — This is a moist, grayish- 
white substance, having the odor of chlorine, and possessing powerful 
bleaching properties. Externally used, it is disinfectant, and, dis- 
solved in water, is applied with advantage to ill-conditioned ulcers, 
burns, chilblains, and eruptions of the skin, also as a gargle in putrid 
sore throat, and as a wash for ulcerated gums, and to purify the 
breath. It has been used with advantage in dysentery, both by mouth 
and injection, to correct the fetor of the stools. 

Lime Water {Aqua Calcis). — This is made by dissolving four 
ounces of lime in a gallon of water, and letting the solution stand 
in a covered vessel, and pouring off the clear liquor when it is wanted 
for use. It is antacid, antilithic, tonic, and astringent, valuable in all 
complaints attended with acidity of the stomach. United with milk, 
and used as the sole diet, it is sometimes the only remedy for chronic 
diarrhoea of long standing. Dose of lime water, half an ounce to 
two ounces. 

Liquorice (Glycyrrhiza Glabra). — This grows in the south of 
Europe and Asia. The root is the part used. It is demulcent and 
expectorant, and is useful in cough, chronic bronchitis, and irritations 
of the mucous surfaces generally. The pulverized root, united with 
an equal amonnt of sulphur, and a little molasses, is a valuable pre- 
paration for coughs. The black extract may be used for the same 
purposes as the root. 

Liverwort (Hepatica Americana). — An indigenous plant, growing 
in woods, upon the sides of hills and mountains. The leaves with- 
stand the cold of winter, and the flowers appear early in the spring. 
The whole plant is medicinal. It is a mild demulcent tonic and as- 
tringent, and has been used in fevers, liver complaints, bleeding from 
the lungs, and coughs. 

Preparations. — Fluid extract, dose, two to three drams ; infusion, 
four ounces to the pint of water, to be taken freely. 

Lobelia {Lobelia Injiata). — This weed grows throughout the United 
States ; both its seeds and leaves are used in medicine. The plant is 
emetic, expectorant, sedative, and antispasmodic. As an emetic, it is 
generally used in combination with other articles for that purpose. 



T^IEDICINES AND THEIR PREPARATIONS. 



627 



Ir is of great advantage in spasmodic asthma, as well as in bronchitis, 
croup, hooping-cough, and other throat and chest affections. When- 
ever relaxation is required to subdue spasm, or for other purposes, 
lobelia will be found useful. 

Preparations. — Fluid extract, dose, as an expectorant, ten to sixty 
drops ; as an emetic, one fourth of a dram to a dram ; tincture, two 
ounces to a pint of diluted alcohol, dose, as an expectorant, one to 
three drams, as an emetic, half an ounce ; infusion, dose, an ounce 
every half hour till vomiting ensues ; lobelin, the active principle, dose, 
half a grain to a grain and a half. The following mixture will be 
found excellent, as an expectorant and sudorific, in spasmodic croup, 
hooping-cough, and asthma, and for subduing mucous inflammation 
about the throat and air passages : tincture of lobelia, half an ounce; 
tincture of bloodroot, two ounces ; oil of spearmint, half a dram ; 
empyreumatic syrup, five ounces ; dose, half a dram every two hours. 
A poultice made of lobelia, elm bark, and weak lye, relieves sprains, 
bruises, rheumatic pains, erysipelatous inflammations, and poison 
from ivy or dogwood. 

FlQ. 210. 



FlQ 


.209. 


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rf-':. 


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^^V 


mr 

M: 




LADIES' SLIPPER. 



Lo2;woo(l {Hcematoxylon Campechianum). — This tree is a native of 
tropical America. The wood is used in medicine. It is tonic and 
astringent, and is used with advantage in diarrhoea, dysentery, and in 
the relaxed state of the bowels after cholora infantum. Used freely 
with other treatment, it also benefits constitutions broken down by 
disease or dissipation. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, five to thirty grains ; infusion, half an ounce to a pint 
of water, dose, four drams every three or four hours, in diarrhoea. 

Magnesia {Magnesia Usta). — Calcined magnesia is obtained from 
carbonate of magnesia, by exposure to a strong heat. It is a white, 
inodorous, light powder, of a feeble alkaline taste. It is antacid and 
laxative, and is much used in dyspepsia, sick headache, gout, and in 
other complaints attended with sour stomach and costiveness ; like- 
wise a favorite remedy in complaints of children. Dose, as a laxative, 



628 MEDICINES AND THEIR PREPARATIONS. 

from thirty to sixty grains ; as an antacid, or antilithic, ten to thirty 
grains, once or twice a day. , 

Carbonate of Magnesia (Magnesice Carbonas). — This is prepared 
from sulphate of magnesia, by carbonate of soda. It is antacid, and 
when it meets with acid in the stomach and bowels, it is laxative. 

Sulphate of Magnesia {Magnesice Salphas). — Obtained from sea- 
water. This is the well-known Epsom salts and is purgative and 
diuretic. Used in all cases which require purgatives. It generally 
operates without griping, and, when united with an acidulated infu- 
sion of roses, will remain on the stomach when all other things are 
rejected. The less it is diluted, the better and more easily it operates, 
provided a draught of warm water be taken an hour afterwards. It 
may be made to act as a diuretic, by keeping the skin cool, and walk- 
ing about after it has been taken. 

Male fern, (Aspidium Filix Mas). — This perennial plant is found in 
both Europe and America, also in Asia and northern Africa. The 
root, which is the medicinal part, should be gathered during summer, 
as the active principle is more abundant at that season than any 
other. It is also said to deteriorate by age, and become nearly worth- 
less in two years. It is slightly tonic and astringent, but its chief 
value consists in its power to destroy and expel the tapeworm. 

Preparations. — Solid extract, dose, nine to fifteen grains. The fol- 
lowing compound pills are adapted to the destruction of the tape- 
worm : solid extract male fern, two scruples ; gamboge, fourteen 
grains ; calomel, fourteen grains ; scammony, eighteen grains. Mix, 
and divide into twenty pills. Dose, two to four pills. 

Mandrake (Podophyllum Peltatum). — This is exclusively an Ameri- 
can, plant. The root is the medicinal part. It is cathartic, alterative, 
anthelmintic, hydragogue, sialagogue, and, in large doses, emetic. It 
stimulates and quickens the action of the liver and kidneys, promotes 
expectoration, and determines the blood to the surface. Combined 
with cream of tartar, it produces watery stools, and is useful in dropsy. 
It is used in jaundice, dysentery, diarrhoea, bilious, remittent, and in- 
termittent fevers, puerperal fever, typhoid fever, and all glandular 
enlargements. But it has a more particular action upon the liver, 
and is especially useful in derangements of that organ. 

The severity of its action seems to be the only objection to its very 
extensive use. Its harshness, however, may be much lessened by its 
combination with castile soap, alkalies, ginger, or caulophyllin. 

Preparations. — Fluid extract, dose, half a dram to a dram ; com- 
pound fluid extract, dose, one to two drams; solid extract, dose, three 
to twelve grains ; tincture, three and a half ounces to one pint of 
alcohol, dose, one to four drams; podophyllin, the active principle, 
dose, as an alterative, one eighth to a quarter of a grain ; as a cathar- 
tic, one to two grains. 

Manna. — This is the concrete juice of the tree called Ornus 
Biiropoea, growing in Sicily, Calabria, and Apulia, as well as of several 
other species of tree. Manna is a gentle laxative, operating mildly. 



MEDICINES AND THEIR PREPAKATIONS. 



629 



though sometimes producing wind and pain. It is considerably used 
as a gentle physic for children, and women in the family way. The 
usual way of prescribing it is in connection with senna, rhubarb, mag- 
nesia, or the neutral salts. Being sweet, it conceals the taste of these 
remedies, in some measure, while it adds to their purgative effect. 
Dose of manna, for a grown person, from one to two ounces ; for a 
child, from one to four drams, according to age. 

Marsh Rosemary {Statice Caroliniana). — This plant grows on the 
coast from Maine to Georgia. The root of it is the medicinal part. 
A decoction of it is much used in diarrhoea, dysentery, etc., also as a 
gargle in ulcerated sore mouth, and the throat affection of scarlet 
fever, and as an injection in gleet, whites, and falling of the womb, 
and bowel. Dose of the decoction, one or two tablespoonfuls, every 
hour or two. 



Fig. 211. 




Fm. 212. 




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MANDRAKE. 



MARSiHMALLOW. 



Marshmallow (Althcea Officinalis). — A perennial plant, growing in 
salt marshes, and other moist places, in Europe. The root is the 
medicinal part, and its properties are those of a demulcent A decoc- 
tion of it is used in irritations and inflammations of mucous mem- 
branes, as in inflammation of the lungs, stomach, bowels, and bladder, 
and some affections of the kidneys. The powdered root, and also the 
leaves and flowers, are sometimes employed in the form of poultice. 

Mastich. — This is the hardened gum or resin which flows from 
incisions in the small tree or shrub pistacia lentiscus, growing upon 
the borders of the Mediterranean. It is not much used in medicine, 
but is chiefly employed in manufacturing a brilliant varnish. I intro- 
duce it here principally for the purpose of recommending the follow- 
ing use of it in carious teeth, — particularly in those new parts of the 
country w^here dentistry is not much known. Dissolve, in a well- 
stopped bottle, four parts of mastich in one part of sulphuric ether. 
Saturate with this solution a small piece of cotton of the size of the 
cavity in the tooth, and then, having cleansed and dried the cavity, 
gently press the cotton into it. The ether will soon evaporate, and 
leave the gum to attach itself to the sides of the tooth, and protect 
its inner surfaces from the action of the air and food. 



630 MEDICINES AND THEIR PREPARATIONS. 

Matico {Piper Angustifolium). — The leaves of this plant are styptic, 
and somewhat stimulant and tonic. The leaves brought in contact 
with a bleeding wound, have considerable power to arrest the flow of 
blood. 

Preparations. — Fluid extract, dose, half a dram to a dram ; tinc- 
ture, four ounces to a pint of diluted alcohol, dose, two drams to an 
ounce ; infusion, half an ounce to a pint of water, dose, one to two 
ounces. 

Meadow Saffron (Colchicum Autumnale). — This is a native of the 
temperate parts of Europe, where it grows wild in moist meadows. 
The roots and seeds are used. Colchicum is justly regarded as a 
valuable remedy in gout and rheumatism, in which it is much and 
chiefly used. It is thought, also, to act upon the nervous system, 
allaying pain, and producing other sedative effects. When not car- 
ried off by the bowels, it produces sweating, and is occasionally 
diuretic and expectorant. Dose of the dried root, from two to eight 
grains. 

Preparations. — Fluid extract of root, dose, three to twelve drops ; 
fluid extract of seeds, dose, five to fifteen drops ; tincture, four ounces 
to twelve ounces diluted alcohol, dose, ten drops to half a dram ; 
syrup, two ounces to fourteen ounces simple syrup, dose, one third of 
a dram to a dram; wine, three. ounces of root to a pint of sherry 
wine, dose, thirty to forty drops. 

Monk's Hood {Aconite). — This is anodyne, sedative, and diapho- 
retic. The leaves and root are generally used separately. It is use- 
ful in inflammatory diseases, neuralgia, epilepsy, paralysis, gout, and 
particularly in fevers. 

Preparations. — Fluid extract, dose, two to six drops ; solid extract, 
dose, one quarter of a grain to a grain ; tincture, eight ounces of the 
root to a pint of alcohol, dose, three to eight drops. 

A preparation composed of one dram of the tincture of aconite 
root, and two ounces of the tincture of black cohosh, and taken in 
doses of one teaspoonful every four hours, has great power in reliev- 
ing the various forms of neuralgia, and also chronic rheumatic pains, 
particularly among old people. 

For nervous headache, irritability, restlessness, and wakefulness, the 
following combination of aconite is useful : 

Solid extract of aconite, half a dram ; solid extract of stramonium, 
four grains ; valerianate of quinia, one scruple. Mix, and divide into 
sixty pills, of which one is to be taken every two, three, or four hours, 
according to symptoms. 

Motlienvort {Leonurus Cardiaca). — This perennial plant is sup- 
posed to be a native of Tartary, and introduced into this country. 
It is considerably used in domestic practice, for nervous complaints, 
and many chronic disorders attended with restlessness, disturbed 
sleep, pains of the nerves, and affections of the liver. A warm infu- 
sion of the tops and leaves is useful in restoring menstrual suppres- 
sion from colds. 



MEDICINES AND THEIR PREPARATIONS. 



631 



Preparation. — Solid extract, dose, three to six grains. Combined 
with blue cohosh and skunk cabbage, the solid extract is a nervine, 
antispasmodic, and emmenagogue. 

Fia, 214. 



Fig. 


213. 


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u 




MEADOW SAFFRON. 



MOUNTAIN LAUREL. 



Mountain Lnurel {Kalmia Latlfolia). — The laurel is found in most 
parts of the United States, on hills and mountains, flowering in June 
and July, and is very ornamental. It is sometimes called big ivy^ or 
calico hush. The narrow-leaf laurel^ or sheep laurel., kalmia ang-nsti- 
folia, is also common, and similarly medicinal. The leaves of these 
plants are used in medicine, and produce, when taken in large doses, 
vertigo, dimness of sight, etc. In medicinal doses, they are sedative and 
astringent. The saturated tincture is the best form of administration, 
which may be taken in ten to twenty-drop doses, every two or three 
hours, in syphilis, active hemorrhages, hypertrophy of the heart, and 
jaundice. 

Mullein ( Verbascum Thapsus). — The leaves and flowers of this bien- 
nial plant are antispasmodic, diuretic, and demulcent. The infusion 
is frequently used in domestic practice, and is useful in colds, coughs, 
bronchitis, etc. ; and may be drank freely. The leaves are sometimes 
boiled in milk, sweetened, and taken for bowel complaints. The 
leaves, dipped in hot vinegar and water, are very useful, applied as a 
fomentation in mumps, acute inflammation of the tonsils, and malig- 
nant sore throat ; a handful of them may also be placed in an old tea- 
pot, with hot water, and the steam be inhaled through the spout, in 
the same complaints. 

Mustard. — The seeds of the white mustard, sinapis alba, were, a 
few years ago, much recommended as a cure for constipation of the 
bowels; and, swallowed whole, in teaspoonful, or even, in some obsti- 
nate cases, in tablespoonful doses, they aflbrd a wholesome stimulus 
to the bowels, and accomplish some good. The ground-mustard is a 
valuable condiment to eat in small quantities, at dinner, in dyspeptic 
cases. It finds its most important uses, however, as a prompt and 
almost instantaneous emetic in cases of poisoning, and also as a val- 
uable counter-irritant, when applied externally. The volatile oil of 
mustard, one part, and ten parts of sweet oil, may be applied to the 
skin, instead of the mustard poultice, and with similar results. 



632 MEDICINES AND THEIR PREPARATIONS. 

Myrrh. — The tree halsamodendron myrrha^ growing in Arabia, etc., 
yields a juice which hardens into a gum-resin, called myrrh. This 
pleasant, aromatic gum, is stimulant, tonic, antiseptic, emmenagogue, 
and expectorant. It is employed in chronic bronchitis, consumption, 
chlorosis, absence of the menses, etc. It is generally combined with 
iron and other tonics, and in amenorrhoea, is frequently combined 
with aloes. Locally, it is considerably used as a wash to improve 
spongy gums, ulcers of the mouth, etc. The dose is from ten to thirty 
grains, to be given in pill, or in powder suspended in water. The 
tincture of myrrh is a useful external application. 

Xaptha. — This belongs to the class of native inflammable sub- 
stances, called bitumens. It is a transparent, yellowish white, very 
light and inflammable liquid, and is found abundantly in Persia. Said 
to have been used with advantage in Asiatic cholera. It is composed 
exclusively of carbon and hydrogen. Dose, from ten to twenty drops, 
given in half a glass of wine, or mint water. During the formation 
of coal gas, an artificial napthia is obtained, which, when purified, 
has the property of dissolving India rubber. 

Medicinally, it is chiefly used for purposes of inhalation, in affec- 
tions of the chest. 

Naphthaline. — This is obtained from a distillation of coal tar. It 
is soluble in ether, alcohol naphtha, and oils, but not in water. It is 
an excellent expectorant, particularly in cases of impending suffoca- 
tion of old persons, from chronic bronchitis ; also in asthma and other 
pectoral affections. Being stimulating, it is improper in acute bron- 
chitis, and pulmonary inflammation. The dose is from ten to thirty 
grains, given in emulsion, or syrup, every fifteen minutes, until abun- 
dant expectoration takes place. A scruple of napthaline, mixed with 
five drams of lard, makes a good ointment for psoriasis, dry tetter, 
and leprosy. 

Nitrate of Silver (Argenti Nitras). — Nitrate of silver is a solution 
of silver in nitric acid, and commonly passes under the name of lunar 
caustic. It is both in the form of small cylindrical rods, and of crys- 
tals, the latter being more pure than the former. 

As an internal remedy, nitrate of silver is tonic and antispasmodic, 
and is given chiefly in nervous diseases, as epilepsy, StVitus's dance, 
and neuralgia of the heart; also in some forms of dyspepsia, attended 
with pain in the stomach, and vomiting. The dose is from one fourth 
to half a grain, in the form of pill. It should never be taken regu- 
larly as an internal remedy, more than three months, as it is apt, after 
long use, to change the skin to an indelible slate blue. 

But nitrate of silver is most used as an external remedy, in pharyn- 
gitis, laryngitis, tracheitis, and other chronic and acute inflammations 
of mucous membranes. For reducing these inflammations, it is very 
nearly a specific ; certainly, it is altogether the best remedy we have. 
It fails in some few cases ; but when skilfully used it never does harm. 
The solutions to be applied to the throat, require to have a strength 
of from fifteen to a hundred and twenty grains to the ounce of soft 



MEDICINES AND THEIR PREPARATIONS. C33 

water. A solution containing one to four or more grains to the ounce 
of water is often used in inflammations of the eye, gonorrhoea, etc. 

Xitre [Potasscc Nitras). — Nitre, which also passes under the name 
of nitrate of potassa, and saltpetre, is both a natural and artificial 
production. As a medicine, it is refrigerant, diuretic, and diaphoretic, 
and is much used in inflammatory diseases. It increases the secre- 
tion of urine and sweat, and lessens the heat of the body, and the fre- 
quency of the pulse. United with tartar emetic and calomel, it forms 
the well-known nitrous powders, which promote most of the secre- 
tions, particularly those of the liver and skin. One of these powders, 
constituting a dose, to be given every two or three hours, is composed 
of eight grains of nitre,.one fourth of a grain of calomel, and one 
eighth of a grain of tartar emetic. 

Sweet Spirit of Xitre (Spiritus JEtheris Nitrici). — Sweet spirit of 
nitre is diuretic, diaphoretic, and antispasmodic. It is deservedly 
much esteemed as a medicine, and is extensively employed in febri 
diseases, either alone, or in union with tartar emetic, or with spirit c 
mindererus. It is often a grateful stimulus to the stomach, relievin 
nausea and vomiting, and promoting sleep. It acts especially upon 
the kidneys, augmenting the secretion of urine, and is often given in 
conjunction with squills, digitalis, and acetate of potassa. The dose 
is a teaspoonful, given in water every two or three hours. 

Xutnie^:; (Mf/ristica Moschata). — The nutmeg is from a tree grow- 
ing in the Molucca Islands. It is stimulant and carminative, and 
somewhat used to remove flatulency, as well as to render other medi- 
cines palatable ; it is most employed, however, to flavor drinks, and 
articles of diet. In large doses, it is poisonous, producing stupor and 
delirium. 

Xux Vomica (Strychnos Nux Vomica). — The tree w^hich produces 
nux vomica, grows in Bengal, Malabar, and the coast of Coromandel, 
and in other regions. The seeds are the me- 

•I- • 1 . ° Fig. 215. 

dicmal part. ^ 

Nux vomica is an emphatic excitant of the 
brain and spinal cord, and, in large doses, is 
an active poison ; frequently repeated in small 
doses, it is tonic, diuretic, and slightly laxative. 

Given in full doses, it is apt to produce mus- 
cular contraction, as in lock-jaw, together with 
frequent starts and twitches, as if from electric 
shocks. It is much employed in treatment of 
paralysis, and is more beneficial in general than 
in partial palsy. 

Preparations. — Fluid extract, dose, two to 
ten drops ; solid extract, dose, half a grain to two grains ; tincture, 
four ounces to the pint of alcohol, dose, five to fifteen drops ; strych- 
nia, commonly called strychnine, the active principle, dose, one six- 
teenth to one eighth of a grain. 

Oil of Cajeput (Oleum Cajuputi). — This oil is obtained from the 

80 




634 MEDICINES AOT) THEIR PREPARATIONS. 

leaves of the East Indian tree cajuputi. It is diaphoretic and anti- 
spasmodic, and a powerful diffusive stimulant. Given in cramps of 
the stomach and bowels, colic, flatulency, hysterics, and chronic rheu- 
matism. It is considerably used as an ingredient in liniments, to be 
applied externally in rheumatism, and neuralgia. Dose, from one to 
five drops, on sugar. 

Oil of Tiirpeutine [Oleum Terebinthince). — This is generally called 
spirits of turpentine, and is obtained by distilling turpentine. As a 
medicine, it is stimulant, cathartic, diuretic, anthelmintic, and astrin- 
gent. In large doses, it causes strangury, and other unpleasant symp- 
toms. The dose is from five to thirty drops, repeated every two or 
three hours. Fifteen drops, taken every fifteen minutes or half hour, 
powerfully restrains bleeding from the lungs, and is, perhaps, the best 
remedy we have for this frightful accident. 

It is also very efficacious in checking other hemorrhages. Exter- 
nally, it is used considerably as an ingredient in liniments and rube- 
facients, in rheumatism, paralysis, etc. Combined with linseed oil, it 
is much used for burns and scalds. 

Olive Oil ( Oleum Olivce). — This oil, often called svjeet oil, is ex- 
pressed from the fruit of the olive tree, Olea Europees. It is nutrient 
and emollient, and in doses of one to two fluid ounces, laxative. It 
is much employed as a constituent of cerates, liniments, and plasters. 

Onion (Allium Cepa). — The medicinal properties of the onion are 
much like those of garlic. The juice, mixed with sugar, is used to 
some extent as a remedy for the coughs and colds of infants. Roasted 
onions, applied as a poultice, hasten the suppuration of boils, tumors, 
etc. They are also useful, in some cases, applied as drafts to the feet. 

Opium. — This is the hardened juice of the unripe seed of the poppy, 
Papaver Somniferum. It is a stimulant narcotic. A moderate dose 
increases the fulness and frequency of the pulse, augments the warmth 
of the skin, invigorates the muscular system, quickens the senses, ani- 
mates the spirits, and gives energy to the mental faculties. Its opera- 
tion is directed with special force to the brain, which it sometimes 
excites to intoxication and delirium, which excitement subsides in a 
short time, and is followed by a dehghtful calmness, and placidity of 
mind, all care and anxiety being banished, and the thoughts yielded 
to the control of pleasing fancies. At the end of an hour or more, 
this reverie is succeeded by sleep, which, at the end of eight or ten 
hours, passes off, and is followed by headache, nausea, tremors, and 
other nervous disturbances. Large doses are followed by shorter 
periods of exhilaration and excitement, and by more protracted sleep. 

Opium is used in medicine to produce gentle perspiration, relieve 
pain, and lessen nervous excitability in all febrile and inflammatory 
diseases ; also as an antispasmodic in hysterics, colic, convulsions, 
coughs, etc. It should not be used in cases of constipation of the 
bowels. A solution, composed of two grains of opium to one ounce 
of water, is sometimes a valuable injection in gonorrhoea and spas- 
modic stricture. Dose, as a stimulant, one quarter to one half a grain; 



MEDICINES AND THEIR PREPAEATIONS. 635 

as a narcotic, one to two grains ; in some spasmodic affections, it is 
given in very large doses. 

^lorpliia, generally called morphine^ is one of the alkaloid principles 
of opium. It is used under the various forms of sulphate^ muriate^ 
acetate^ and valerianate of morphia, — all having the general properties 
of opium, and are given for similar purposes, in doses of one eighth 
to one quarter of a grain. One sixth of a grain is equal to one grain 
of opium. 

Strong coffee is an excellent antidote to the poisonous eflects, both 
of opium and morphia. A solution of morphia may be made by 
adding ten grains of the salt to one fluid ounce and a half of distilled 
water, and half an ounce of diluted alcohol, and then adding two 
drops of sulphuric acid, if it be the sulphate of morphia, or two drops 
of acetic acid, if it be the acetate of morphia, or two drops of muri- 
atic acid, if it be the muriate of morphia. The effects of morphia 
may be obtained by sprinkling some of it on a blistered surface. 

Oraiio'e Peel {AuraMii Cortex), — The orange is the fruit of a tree 
belonging to the tropical climates. Orange juice is a pleasant refrig- 
erant, useful in fevers, and particularly in scurvy. Sick persons suck- 
ing the juice of the orange, should be careful not to swallow any of 
the skinny portion, or the peel. The peel of the orange is chiefly 
employed to give a pleasant flavor to other medicines, and to prevent 
their nauseating properties. It is a mild tonic, carminative, and stom- 
achic, and improves the bitter infusions and decoctions of gentian, 
quassia, columbo, and peruvian bark. Orange peel should never be 
given in substance. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
tincture, one ounce and three quarters to a pint of diluted alcohol, 
chiefly used as an addition to infusions, etc.; syrup, two ounces fluid 
extract or tincture to a pint of simple syrup, used with water as an 
agreeable drink. 

Orig'anniii (Orig-anum Vulgare). — A perennial herb growing in 
Europe and this country. The warm infusion of it causes perspira- 
tion, and promotes the menstrual discharge, when interrupted by a 
cold. The oil of origanum is a very useful ingredient, in several 
stimulant and rubefacient liniments. 

Parsley (Petroselinum Sativum). — The root of this biennial plant 
is aperient and diuretic, and is used in dropsy, scarlet fever, and dis- 
eases of the kidneys ; also in retention of the urine, gonorrhoea, and 
strangury. The dose of the infusion is from two to four fluid ounces, 
two or three times a day. 

The bruised leaves are applied with advantage to contusions, 
swelled breasts, and enlarged glands. 

Partridge Berry (Mitchella Repens). — This perennial, evergreen, 
creeping herb, grows in dry woods and swampy places throughout 
the United States, and has white, fragrant flowers in June and July. 
It is parturient, diuretic, and astringent, and is used in dropsy, sup- 



636 



MEDICINES AND THEIR PREPARATIONS. 



pression of urine, and diarrhoea. It acts as a tonic upon the repro- 
ductive organs, giving tone and vigor to the womb, and making labor 
less tedious. Dose of the decoction, from two to four fluid ounces, 
two or three times a day. 

Peacli (Amygdalus Persica). — The leaves of the peach are sedative 
and slightly laxative, and are used in inflammations of the stomach 
and bowels ; likewise in irritable bladder, hooping-cough, sickness at 
the stomach, and dysentery. They are used in the form of cold infu- 
sion, a tablespoonful being a dose, to be taken every hour or two. A 
good tonic is made by adding four ounces of the bruised kernels to a 
quart of honey. 

Pennyroyal {Hedeoma Pulegioides). — Pennyroyal is a gently stim- 
ulant aromatic ; it relieves wind colic and sick stomach, and qualifies 
the action of other medicines. Like most aromatic herbs, it has the 
property, when given as a warm infusion, of promoting perspiration, 
and of exciting the menses, when the system is already disposed to 
the effort. In cases of recent suppression, it may be given at bed- 
time as a warm tea, after bathing the feet in warm water. The oil 
of pennyroyal has the properties of the herb. 



Fig. 216. 



Fig. 217. 





PENKTKOYAL. 



PERUVIAN BABK. 



Peppermint {Mentha Piperita). — The peppermint is a native of 
England, where it is largely cultivated, as it is to some extent in this 
country, for the sake of its essential oil. It is a valuable herb, having 
a strong aromatic smell, and a pungent, warming taste. It may be 
used in the form of tea, which, when largely drank, imparts warmth 
to the system. It is valuable in colds, flatulent colic, hysterics, spasms, 
cramps in the stomach, nausea, and vomiting, and to disguise unpleas- 
ant medicines. 

The peppermint furnishes an essential oil, which, dissolved in alco- 
hol, forms the essence of peppermint. The dose of this is fifteen to 
thirty drops, on a lump of sugar, or in sweetened water, warm or cold. 



ISIEDICINES AND THEIR PREPARATIONS. 637 

Persimnioii (Diospyros Vir^iniana). — This is a tree growing in 
the Southern and Middle States. The bark and unripe fruit are 
used in medicine, — being astringent and tonic. Persimmon has been 
found useful in chronic diarrhoea, chronic dysentery, hemorrhage from 
the womb, and fever and ague. It is used in the form of infusion 
and syrup, in doses of a tablespoonful, every two or three hours. The 
infusion is also used as a wash and gargle in sore mouth and throat, 
and as an injection in whites. 

Peruvian Bark ( Cinchona). — This valuable bark is derived from 
several species of the cinchona tree, on the western coast of South 
America. The remedy is said to have been first introduced into 
Europe in 1640, by the Countess of Cinchon, wife of the Viceroy 
of Peru, on her return to Spain. 

There are three varieties of this bark : the pale, the red, and the 
yellow. The pale bark is least liable to offend the stomach, and is 
perhaps the best as a general tonic ; but for the treatment of fever 
and ague, the red and the yellow are both preferable to the pale, and 
the red is considered better than the yellow. 

Cinchona is tonic and antiperiodic, and is much used, and with 
great success, in all periodical diseases, as fever and ague, remittent 
fever, neuralgia, and epidemic diseases ; also in chronic diseases at- 
tended with debility, as scrofula, dropsy, and affections of the skin. 
Dose of the powdered bark, as a tonic, from ten to sixty grains ; as 
an antiperiodic, from twenty to a hundred grains. 

Preparations. — Fluid extract, dose, half a dram to a dram; com- 
pound fluid extract, dose, half a dram to a dram ; tincture, four ounces 
to one pint diluted alcohol, dose, one to four drams ; infusion, dose, 
one to two ounces. A good compound infusion of cinchona is made 
by combining one ounce fluid extract with half an ounce of fluid 
extract of snake-root, two drams of fluid extract of orange peel, one 
dram of fluid extract of cloves, one dram of carbonate of potassa, and 
one pint of water. Dose, one to one and a half ounces. The follow- 
ing is a good nervine and tonic for persons of nervous temperaments : 
fluid extract of cinchona, one ounce ; fluid extract of valerian, one 
ounce; essence of cardamom, two drams; dose, one dram every three 
hours. 

Cinchonia is a white crystalline substance obtained from the peru- 
vian bark. It is sometimes used as a substitute for quinia, in doses 
of from one to four grains, three times a day. 

Sulphate of Quinia is snow white, and in satin-like crystals, having 
an exceedingly bitter taste. It is completely soluble in w^ater, or alco- 
hol, by adding a few drops of sulphuric acid. It is the chief active 
principle of cinchona, and has similar properties, namely, febrifuge, 
tonic, and antiperiodic ; it is, however, less apt to nauseate and op- 
press the stomach. In the treatment of intermittent fevers, it has 
almost entirely superseded the use of the bark. 

Valerianate of Quinia. — This is a combination of quinia and vale- 
rianic acid. It is tonic febrifuge and sedative. It is used for head- 



638 



MEDICINES AND THEIR PREPARATIONS. 



ache of a periodic character, and for nervous irritability, wakefulness, 
restlessness, etc. Dose, from half a grain to two grains. 

Peti'olium. — This is a blackish liquid bitumen, flowing spontane- 
ously from the earth in Italy, France, West India Islands, etc. As a 
medicine, it is stimulating, antispasmodic, and sudorific. It is occa- 
sionally administered in affections of the chest, when not attended 
with inflammation. Externally, it is employed in chilblains, chronic 
rheumatism, paralysis, diseases of the joints, and affections of the 
skin. It is an ingredient in the well-known remedy called British 
oil. The petrolium found in the State of New York, and called 
Seneca oil, is extensively used in domestic practice. The dose of 
petrolium is from thirty drops to a dram. 

PhosphoniS. — This is a semi-transparent solid, and is flexible, and 
has a waxy lustre. It is extracted from bones by sulphuric acid. As 
a medicine in^small doses, it acts as a powerful general stimulant ; in 
large doses, as a violent, irritant poison. When taken in substance 
it causes irritation of the stomach, and should, therefore, always be 
administered in solution ; and even in this form it is objectionable ; it 
is better to resort to the phosphates, and the hypophosphites. Phos- 
phorus, being an element in the composition of the brain, has been 
given, and with advantage, in the various forms of nervous debility, 
as consumption, typhus fever, amaurosis, paralysis, and the general 
breakdown of the vital powers. Phosphorus burns when exposed to 
the air, and should therefore be kept covered with water. 



Fig. 218. 



Fig. 219. 





PINK BOOT. 



PIPSISSEWA. 



Pink Root (Spig-elia Marilandica). — This perennial herb grows in 
rich soils in the Middle and Southern States. The root is the medici- 
nal part. It is a powerful anthelmintic, and is but little used, except 
for expelling worms. 

Preparations. — Fluid extract, dose, half a dram to a dram and a 
half ; compound fluid extract, dose, half a dram to two drams ; fluid 



ISIEDICINES AND THEIR PREPARATIONS. 



689 



extract of pink root and senna, dose, half a dram to a dram ; infusion, 
half an ounce to a pint of vv^ter, dose, two to six ounces. 

Pipsissewa (Chimaphila UmbeUata). — This is a small evergreen 
plant, growing in the United States, and in Northern Europe and 
Asia. It is known by the name of princes' pine. The whole plant is 
tonic, diuretic, and astringent, and has proved itself useful in dropsy, 
general debility, rheumatism, chronic disorders of the kidneys, bladder, 
urethra, etc. 

Preparations, — Fluid extract, dose, one dram ; solid extract, dose, 
ten to twenty grains ; infusion, dose, two ounces. 

Plantain {Plantag-o Major). — This perennial herb grows both in 
Europe and America. A strong decoction of the tops and the roots 
is highly spoken of for syphilis and scrofula; the dose being from two 
to four fluid ounces, two or three times a day. But the bruised leaves 
are most useful, when applied to wounds, ulcers, bites of poisonous 
insects, erysipelas, etc. 

Plenrisy Root (Asclepias Tuberosa). — This perennial plant is abun- 
dant in the Southern States. The root, which is the part used, is 
carminative, tonic, and diuretic; used in pleurisy, bronchitis, inflamma- 
tion of the lungs, acute rheumatism, and dysentery. The warm infu- 
sion promotes diaphoresis, without raising the temperature of the 
body. United with the warm infusion of wild yam root, it is excel- 
lent for flatulency and wind colic. 

Preparations. — Fluid extract, dose, half a dram to two drams ; 
tincture, four ounces to a pint of diluted alcohol, dose, three to five 
drams ; infusion, dose, one to four ounces ; asclepidin, dose, one to five 
grains. Asclepidin and dioscorein, united in equal parts, make a valua- 
ble preparation for flatulent and bilious colic ; dose, two to four grains. 



Fig. 220. 



Fig. 221. 







PLEURIST ROOT. 



POISON HEMLOCK. 



/ Poison Hemlock (Conium Maculatum). — This biennial plant is a 
/ native of Europe and Asia, and is naturalized in this country. The 
leaves and the seeds are used in medicine. Conium is narcotic, ano- 
dyne, antispasmodic, and deobstruent ; ufeed in neuralgia, asthma, 
syphilis, chronic rheumatism, and various other affections. 



640 



MEDICINES AND THEIR PREPARATIONS. 



Fig. 222. 



Preparations, — Fluid extract, dose, five to twenty drops ; solid 
extract, dose, half a grain to two grains ; tincture, three ounces to a 
pint of diluted alcohol, dose, thirty drops to a dram; infusion, half 
an ounce to a pint of water, mainly used as a wash for malignant 
ulcers, etc. 

Poison Oak (Rhus Toxicodendron). — The leaves are the medicinal 
part of this creeping shrub, which is common in this country. The 
form of using this medicine is that of a saturated tincture, made from 
the fresh leaves, and to be kept in well-corked vials. It has been 
found useful in paralysis of the bladder and rectum, in diseases of 
the eyes and skin, and in chronic rheumatism. Dose of the tincture, 
from five to ten drops, three times a day. Large doses should be 
avoided. 

Poke (Phytolacca Decandra). — A perennial plant, growing in nearly 
all parts of the country, and called garget, pigeon-berry, and scoke. 
The root is the part used. It is emetic, cathar- 
tic, alterative, and slightly narcotic. It excites 
the whole glandular system, and is used in 
syphilis, scrofula, rheumatism, and affections of 
the skin. The root, buried in hot ashes until 
soft, and then mashed, and applied as a poul- 
tice, is said, in King's Dispensatory, to be un- 
rivalled in felons and various tumors. Dose 
of the powdered root, as an emetic, twelve 
grains to half a dram ; as an alterative, from 
two to six grains. 

Preparations. — Fluid extract, dose, ten to 
thirty drops ; solid extract, dose, one to four 
grains ; tincture, four ounces to a pint of di- 
luted alcohol, dose, half a dram to a dram ; 
syrup, two ounces to fourteen ounces of sim- 
ple syrup, dose, one to two drams ; phytolaccin, the active principle, 
dose, one quarter to one grain. For mercurial and syphilitic pains 
in the bones, the following pill is useful : solid extract of poke, two 
drams ; solid extract of stillingia, one dram ; solid extract of stramo- 
nium, eight grains. Mix, and divide into sixty piUs, of which one pill 
is to be taken every one, two, or three hours. 




Potassa. — This is used in medicine under the name of caustic 
potassa. It is made by boiling a solution of potassa in a clean iron 
vessel until ebullition ceases, and the potassa melts, and then pouring 
it into cylindrical moulds ; when cold it is to be kept in well-stopped 
bottles. It is a very powerful escharotic, quickly destroying the flesh 
which it touches, and extending its action deep under the surface. It 
differs in this respect from nitrate of silver, which only acts upon the 
surface, and is not, properly speaking, a caustic. 

Caustic potassa is used for forming issues. The method of using 
it for this purpose is to cut in a piece of adhesive plaster, a hole as 
large as the desired issue, and then, having stuck this upon the skin. 



MEDICINES AND THEIR PREPARATIONS. 641 

to apply the end of the caustic, previously moistened, to the opening. 
This application is to be continued till the life of the part is destroyed, 
when the caustic must be neutralized by vinegar, or carefully washed 
oft" with a wet sponge. 

The following preparations of potassa are used in medicine : 

Acetate of Potassa (Potasses Acetas). — This is made by the union 
of acetic acid and carbonate of potassa, and in consequence of its 
extreme deliquescence when exposed to the air, it is kept in closely- 
stopped bottles. It is diuretic, deobstruent, and mildly cathartic. It 
is used in febrile diseases, several skin diseases, such as psoriasis, 
eczema, and lepra, and particularly in dropsical affections. Dose, as 
a diuretic, from twenty to thirty grains ; as an aperient from two to 
three drams. 

Bicarbonate of Potassa (Poiassce Bicarhonas). — This is a solution 
of carbonate of potassa, saturated with carbonic acid. This acid is 
diuretic,' antacid, and deobstruent; used in dropsy, acidity of the 
stomach, and glandular obstructions. Dose, ten to thirty grains. 
Twenty grains dissolved in eight fluid ounces of water, and mixed 
with four fluid drams of lemon juice, forms a good effervescing 
draught. 

Bitartrate of Potassa {PotasscB Bitartras). — This salt is better 
known as cream of tartar^ and super tartrate of potassa. It is formed 
from the matter deposited on the bottom and sides of casks, during 
the fermentation of sour wines. As a medicine it is diuretic, cathar- 
tic, and refrigerant. In small doses, it acts as a cooling aperient, 
gently opening the bowels ; in large ones, as a hydragogue cathartic, 
causing free, watery stools. This property, as well as its power of 
acting upon the kidneys, causes it to be much used in dropsical com- 
plaints. Dissolved in boiling water, allowed to cool, and then sweet- 
ened with loaf sugar, it forms a cooling, pleasant, acid drink. This 
kind of solution, with a little fresh lemon peel added to it, forms the 
drink called imperiaL Combined with sulphur, it is often used in 
skin diseases. Dose, as an aperient, a dram or two ; as a hydragogue 
cathartic, half an ounce to an ounce ; as a diuretic in dropsical com- 
plaints, a dram and a half to two drams, several times a day. Cream 
of tartar, powdered rhatany, and myrrh, mixed in equal proportions, 
form a good preparation for cleansing the teeth. 

Carbonate of Potassa (Potassce Carbonas). — Carbonate of potassa 
is purified pearlash^ and is frequently called salt of tartar. The com- 
mon saleratus is a composition between the carbonate and bicarbo- 
nate. Carbonate of potassa has the same medicinal properties with 
the bicarbonate, and is used for similar purposes. 

Clilorate of Potassa. — This is prepared by passing an excess of 
chlorine through carbonate of potassa. It is refrigerant and diuretic, 
and is given in scurvy, scarlet fever, etc., and as a wash in canker in 
the mouth, and various unhealthy ulcers, and as an injection in leu- 
corrhoea and gleet. 

81 



642 MEDICINES AND THEIR PREPARATIONS. 

Citrate of Potassa (Potassm Citras). — A grateful, cooling diapho- 
retic, long and nnuch used in fevers, chiefly in the forms of the neutral 
mixture^ and effervescing draught. 

Solution of Citrate of Potassa (Liquor Potassce Citratis). — This is 
prepared by taking half a pint of leuion juice, and adding bicarbonate 
of potassa gradually to it, until it is saturated, then filtering. This 
passes under the name of neutral mixture^ saline mixture, and efferves- 
cing- draught. It is a valuable refrigerant diaphoretic, well adapted 
to the hot stage of remittent and intermittent fevers, and indeed to 
almost all cases of fever, with a dry, hot skin. The dose is a table- 
spoonful, or half a fluid ounce, which should be diluted when taken, 
and be repeated every one, two, or three hours, according to the neces- 
sities of the case. 

Solution of Potassa (Liquor Potassce). — This is a transparent, caus- 
tic fluid, which requires to be kept in green bottles, tightly corked. 
It is antacid, antililhic, and diuretic. It is used in some affections 
of the skin, and scrofula, but more particularly for scalding of the 
urethra, in gonorrhoea ; in this case, it is well to unite a few drops 
of laudanum with it. The dose is from fifteen to forty drops, two or 
three times a day, in half a tumblerful of water. In dyspeptic cases, 
attended wiih acidity of the stomach, it may be associated with some 
simple bitters. 

Sulphate of Potassa (Potassce Sulphas). — This is a mild purgative, 
operating without irritation or pain. As an aperient, it should be 
given in doses of from a scruple to a dram. Ten grains of rhubarb 
and one dram of carbonate of potassa, united, and divided into six 
powders, is an excellent alterative cathartic for children having defec- 
tive digestion and nutrition, and a tumid state of the abdomen. One 
powder may be given at a time, as often as may be necessary to open 
the bowels gently. 

Tartrate of Potassa (Potassce Tartras). — This often passes under 
the name of soluble tartar. It is a mild, cooling purgative, operating, 
as most of the neutral salts do, without much pain, and producing 
watery stools. It is useful in fevers. Combining it with senna, de- 
stroys its tendency to produce griping of the bowels. The dose 
varies from a dram to an ounce, according to the effect desired. 

Potassium. — This is a soft, bluish-white metal. Its union with 
oxygen, in the proportion of one equivalent of each, forms potassa or 
potash. The following preparations of it are used in medicine : 

Bromide of Potassium (Potassii Bromidum). — This is a permanent, 
colorless salt, having a pungent, saline taste, a little more acrid than 
common salt, yet similar to it. As a medicine, it is alterative and 
resolvent, and is used occasionally for secondary syphilis, scrofula, 
and enlarged spleen. Dose, from three to ten grains, three times a 
day, in pill or solution. One dram of the bromide of potassium, 
rubbed up with an ounce of lard, makes an ointment which has been 
used with some good effect in goitre, and scrofulous affections. 



MEDICINES AND THEIR PREPARATIONS. 



643 



Tig. 223. 



Cyaiiuret of Potnssiimi (Potassii Cyanuretum). — This is eminently 
poisonous, acting both as a medicine and as a poison, like hydro- 
cyanic acid. It has therefore been recommended as a substitute for 
that acid. The dose is one eighth of a grain, dissolved in half a fluid 
ounce of water. 

Sulphuret of Potassium (Potassii Sulphnretum). — This is called 
liver of sulphur, and hepar, being composed of sulphur and potassium. 
It has been used in chronic bronchitis, asthma, hooping-cough, and 
rheumatism. Half an ounce to an ounce of it, dissolved in several 
gallons of warm water, makes a valuable sulphur bath for several skin 
diseases, as itch, prurigo, etc. 

Prickly Ash [Xanthoxylum Fraxineum). — This shrub grows in 
various parts of the United States. The leaves and capsules have 
a pleasant, aromatic smell. Its medicinal properties 
are in the bark and berries. The bark is stimulant, 
tonic, alterative, and sialagogue. It is used to rouse 
and excite the system, when in a languid state, and 
for derangements of the liver, rheumatism, and chronic 
syphilis. It stimulates and strengthens mucous mem- 
branes, and is a valuable tonic in low typhoid fever. 
Applied externally, it improves indolent and malig- 
nant ulcers. Dose of the powdered bark, from ten to 
thirty grains, three times a day. 

Preparations. — Fluid extract, dose, fifteen to forty- 
five drops; tincture, four ounces to a pint of diluted 
alcohol, dose, hall a dram to a dram and a half; infu- 
sion, half an ounce to a pint of water, dose, half an 
ounce to two ounces ; xanthoxylin, the active princi- 
ple, dose, two to six grains. 

For chronic rheumatism, the following is a good 
preparation : xanthoxylin, one dram ; cimicifugin, one dram ; apocy- 
nin, one dram ; diluted alcohol, one pint ; dose, four drams, three 
times a day. 

Prickly Ash Berries are carminative, antispasmodic, and stimulant, 
and have a special direction to mucous membranes. The tincture is 
excellent in nervous diseases, spasms of the bowels, flatulency, and 
diarrhcea ; and, combined with the tincture of poke berries, is very 
serviceable in chronic rheumatism and syphilis. It is said to have 
been used with great success, in the West, in Asiatic cholera. Dose 
of the tincture, from ten drops to a fluid dram, in sweetened water. 
Dose of the oil of prickly ash berries, from two to ten drops, on sugar. 




PRICKLY ASH. 



Prickly Elder (Aralia Spinosa). — This is a tree which grows in 
the Southern and Western States, and is called southern prickly ash, 
and toothache tree. The bark is stimulant, alterative, and diaphoretic. 
The fresh bark, emetic and cathartic. The tincture is serviceable in 
skin diseases, syphilis, and chronic rheumatism. Dr. John King re- 
ports, that in the cholera of 1849, it was found very serviceable, where 
cathartics were required, in the following combination : compound 



644 MEDICINES AND THEIR PREPAKATIONS. 

powder of jalap, one dram ; powdered prickly elder bark, one dram ; 
compound powder of rhubarb, two drams. These were mixed, and 
given in half-teaspoonful doses, every half hour, or hour, until they 
operated. The bark is sialagogue, and, in small doses, powdered, is 
said to relieve the dry and parched condition of the throat, in many 
diseases. 

Pumpkin Seeds, — The infusion of pumpkin seeds, made by placing 
them in water without bruising them, are mucilaginous and diuretic, 
and are used in inflammation of the stomach and bowels, scalding of 
the urine, strangury, etc. But this infusion is more particularly valu- 
able for its power of expelling the tape-worm. It may be drank 
freely. The oil of pumpkin seeds, obtained by expression, has simi- 
lar properties, and may be taken in doses of six to twelve drops, 
several times a day. 

Quassia (Picroena Excelsa) — This is the wood of a tall tree grow- 
ing in Surinam and some of the West India Islands. It is an in- 
tensely bitter tonic, febrifuge, and anthelmintic, possessing in the 
highest degree, the properties of the simple bitters. It invigorates 
the digestive organs, without producing much excitement of the cir- 
culation. It is well adapted to dyspepsia and the debility of the 
stomach which succeeds acute disease, and indeed all complaints 
where simple bitter is required. Its generic title perpetuates the name 
of the negro Quassi, of Surinam, who first discovered its medicinal 
virtues, about the middle of the last century, and who became famous 
for treating malignant fevers with it, as a secret remedy. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, three to five grains ; tincture, dose, four to eight drams ; 
infusion, two drams to a pint of water, dose, two to four ounces. 

Queen of the Meadow {Eupaiorium> Purpureum) — This perennial 
herb grows in low, swampy places, in many parts of this country. It 
is called trumpet iveed, and, from its fine medicinal effects in com- 
plaints of the urinary organs, gravel root. It is an excellent diuretic, 
tonic, and stimulant. Used in gout, rheumatism, hematuria, chronic 
diseases of the urinary organs, strangury, gravel, and dropsical affec- 
tions. The decoction is the form in which it is most used ; the dose 
being two to four ounces, two or three times a day. 

A preparation called eupurpurin is also extracted from it, which, in 
three-grain doses, is a powerful diuretic, occasioning, in some cases, it 
is said, an enormous flow of urine. 

Queen's Root [Stillingia Sylvatica). — This perennial herb grows 
in sandy soils in the Southern States. The root is medicinal, being 
in large doses, emetic and cathartic ; in small doses, an alterative of 
considerable value in skin diseases, rheumatism, syphilis, and scrofula, 
and in such other complaints as require alteratives. 

Preparations. — Fluid extract, dose, five to fifteen drops ; compound 
fluid extract, dose, half a dram to a dram ; tincture, two ounces to a 
pint of diluted alcohol, dose, one to three drams ; infusion, dose, one 
to two ounces. In chronic bronchitis, and similar complaints, the 



MEDICINES AND THEIR PREPARATIONS. 645 

following syrup is well recommended : fluid extract of stillingia, two 
ounces; fluid extract of bloodroot, two ounces; fluid extract of cherry 
bark, two ounces ; balsam of tolu, one ounce and a half ; syrup, two 
and a half pints. Dose, one to two drams. 

Red Chickweed (Anag-allis Arvensis). — An annual plant, common 
in Europe and this country. It has small scarlet flowers in June and 
July. It has been used in nervous diseases, as mania, delirium, epi- 
lepsy, and particularly hydrophobia. Old and ill-conditioned ulcers 
are improved by its use, in the form of poultice. 

Red Root (Ceatwthus Americanus). — This shrubby plant has the 
names of New Jersey Tea and wild snow-ball^ and is found in all parts 
of the United States. The bark is antispasmodic, sedative, astrin- 
gent, and expectorant, and tastes and smells like the peach leaf. A 
decoction is useful in dysentery, diarrhoea, hooping-cough, and chronic 
bronchitis, in doses of a tablespoonful, three times a day. It makes, 
likewise, a very good injection in leucorrhoea and gleet, and gargle 
for ulcerations of the mouth and throat. 

Red Clover ( TrifoHum Pratense). — The blossoms of this very com- 
mon biennial plant are medicinal, and are highly recommended in 
deep, ragged, and cancerous ulcers, as well as in badly-conditioned 
burns. They are soothing and detergent, and promote healthful 
granulation. 

Preparation. — Solid extract, to be used as an external application, 
chiefly in the form of ointment, made by uniting four ounces of it 
with half a pound of lard. 

Red Rose (Rosa Gallica). — The petals of the rose are slightly tonic 
and astringent, and are considerably employed in chronic inflamma- 
tions of the eye. Rose water, distilled from the petals, is used for 
similar purposes. 

Red Saunders (Pterocarpus Santalinus). — This is a large tree grow- 
ing in Ceylon, the wood of which imparts a red color to alcohol, 
ether, and alkaline solutions, but not to water. It is almost solely 
used for imparting color to tinctures, etc., having little or no medici- 
nal properties. 

Rosin. — This is the solid resinous matter which remains after the 
distillation of turpentine. It is much used as an ingredient in oint- 
ments and plasters, but is never taken internally. The vapor which 
arises from heating it upon some hot surface is sometimes inhaled 
with great advantage in chronic bronchitis, and other chronic aft'ec- 
tions of the air tubes. 

Rkatany (Krameria Triandra). — This is a native of Peru, growing 
in dry, sandy places. It is a powerful astringent, and a gentle tonic. 
It is given with advantage in excessive menstruation, vomiting of 
blood, chronic diarrhoea, leucorrhoea, and inability to retain the urine ; 
likewise, as a local application in falling of the bowel. It is valuable 
also for nose-bleed, and bleeding gums. Dose of the powder, for in- 
ternal use, from ten to thirty grains. 



646 MEDICINES AND THEIR PREPARATIONS. 

Preparations. — Fluid extract, dose, half a dram to a dram; solid 
extract, dose, five to twenty grains; tincture, three ounces to a pint 
of diluted alcohol, dose, three to six drams ; infusion, two ounces to 
a pint of water, dose, half an ounce to an ounce. 

Rhubarb (Rheum Palmatum). — This root is derived from several 
species of rheum, and passes under the various names of European^ 
Russian^ Chinese^ East India, and Turkey rhubarb. The variety called 
Russian, or Turkey rhubarb (for they are the same), is considered the 
best. Rhubarb is cathartic, astringent, and tonic. It is much used 
in mild cases of diarrhcea and cholera infantum ; likewise, as a stom- 
achic and gentle tonic in dyspepsia, accompanied with a debilitated 
state of the digestive organs. It is a valuable remedy in the com- 
plaints of children, and is deservedly much used in treating them. It 
acts upon the muscular coat of the bowels, producing thick rather 
than watery stools. It is therefore not adapted to the treatment of 
dropsical complaints. Its astringency may be increased by roasting 
it, or diminished, by combination with soap, or an alkali. 

Preparations. — Fluid extract, dose, half a dram to a dram ; aro- 
matic fluid extract, dose, half a dram to a dram ; fluid extract of rhu- 
barb and senna, dose, half a dram to a dram ; solid extract, dose, two 
to ten grains ; tincture, an ounce and a half of fluid extract, and half 
an ounce of essence of cardamom, to a pint of diluted alcohol, dose, 
half an ounce to an ounce and a half; infusion, one ounce fluid ex- 
tract and two ounces spirit of cinnamon to a pint of water, dose, one 
to three ounces ; syrup, three ounces of fluid extract to fourteen of 
syrup, dose, two to five drams. 

J!io^%m9iXy (Rosmarinus Officinalis). — This evergreen shrub grows 
on the borders of the Mediterranean, and is cultivated in Europe and 
this country. It is stimulant, antispasmodic, and emmenagogue. It 
is not used, in this country, however, except to perfume ointments, 
tinctures, and syrups. 

Round-Leaved Pyrola (Pyrola Rotundifolia). — This perennial shrub 
grows in various parts of our country, and bears white flowers in 
June. It is called canker lettuce, pear-leaf winterg-reen, etc. Its me- 
dicinal properties are those of a tonic, astringent, antispasmodic, and 
diuretic. Used in decoction for epilepsy and other nervous disorders ; 
also for gravel, and other diseases of the bladder and kidneys. The 
decoction may be used, too, as a wash for ulcerations of the mouth, 
indolent ulcers, and chronic opthalmia. The decoction may likewise 
be used in making poultices for painful swellings, boils, and carbun- 
cles. It may be taken in doses of from one to six ounces. 

Rue (Ruta Graveolens). — Rue has the medicinal virtues of the 
antispasmodics, anthelmintics, and emmenagogues. In large doses, it 
is poisonous. It is useful in wind colic, worms, hysterics, epilepsy, 
etc. Dose of the leaves, from ten to twenty grains ; of the infusion, 
from one to four ounces. 

SaiTron (Crocus Sativus). — This is a native of Greece and Asia 
Minor ; it is also cultivated in France, England, and America, as well 



MEDICINES AND THEIR PREPARATIONS. 647 

as in other countries. It has been thought to be stimulant and anti- 
spasmodic, in small doses, relieving pain, and producing sleep; in large 
doses, giving rise to headache, and producing stupor. In the general 
judgment of the profession, it is now considered, however, as having 
very little activity. It is accordingly not much used, except in do- 
mestic practice, where it has some reputation among nurses for its 
power to bring out measles, and other eruptions. It is also thought 
to be beneficial in amenorrhoea, dysmenorrhoea, chlorosis, and hysteria. 
It is chiefly used at present to impart flavor and color to tinctures. 

Preparations. — Fluid extract, dose, twenty to sixty drops ; tincture, 
dose, half a dram to a dram ; infusion, one dram to a pint of water, 
dose, two to three ounces. 

S;l<^e ( Salvia Officinalis). — The tops and leaves of this well-known 
garden plant are aromatic, astringent, diaphoretic, and slightly tonic. 
The infusion is useful in debilitated conditions of the stomach, at- 
tended with flatulence ; it frequently relieves nausea ; the cold infu- 
sion checks and sometimes entirely removes the night-sweats of 
hectic. The infusion is useful as a gargle in inflammation of the 
throat, particularly, if united with a little honey and alum. Dose of 
the infusion, from one to three fluid ounces. 

8arsiiparilla (Sniilax Officinalis). — Grows in swamps and hedges 
in the Middle and Southern States. The root has long been held in 
esteem as an alterative, diuretic, and demulcent, being used in scrofula, 
chronic rheumatism, and affections of the skin; but its most exten- 
sive and useful application has been found to be in the treatment of 
secondary and tertiary syphilis ; and especially in the broken condi- 
tion of the system which follows the use of mercury in these affec- 
tions. 

Preparations. — Fluid extract, dose, one dram ; fluid extract of sar- 
saparilla and dandelion, dose, one dram ; solid extract, dose, five to 
twenty grains ; infusion, dose, two to four ounces. 

Sassafras (Laurus Sassafras). — This tree is common in the United 
States. The bark of the root, which is the medicinal part, is altera- 
tive, diuretic, diaphoretic, and a warm aromatic stimulant. It is 
mainly used to improve the flavor of other medicines, and also, as a 
constituent of those compounds, which are recommended in chronic 
rheumatism, syphiloid affections, eruptions of the skin, and scurvy. 

Preparations. — Fluid extract, dose, one to two drams ; tincture, 
six ounces to a pint of alcohol, dose, half an ounce to an ounce ; in- 
fusion, two ounces to a pint of water, to be drank as desired. 

Savin (Juniperus Sabina). — An evergreen shrub, growing in Europe 
and North America. The tops and leaves are diuretic, diaphoretic, 
emmenagogue, and anthelmintic. The warm infusion promotes men- 
struation, and destroys worms. Care should be taken never to ad- 
minister this medicine during pregnancy, its effects being violent and 
dangerous. 

Preparations. — Fluid extract, dose, ten to thirty drops ; solid ex- 
tract, dose, one to five grains ; tincture, four ounces to a pint of diluted 



648 



MEDICINES AND THEIR PREPARATIONS. 



alcohol, dose, half a dram to a dram and a half; infusion, half an 
ounce to a pint of water, dose, half an ounce to an ounce. The fol- 
lowing mixture is useful in amenorrhoea ! fluid extract of savin, half 
a dram ; fluid extract of ginger, one dram ; sulphate of potassa, two 
drams. Mix. Dose, half a dram, twice a day. The oil of savin has 
properties similar to those of the leaves. Dose, from two to five 
drops, on sugar. 

Scammony [Convolvulus Scammonia). — This plant is a native of 
Syria, and the neighboring countries. The medicinal part is the 
hardened juice of the fresh root. It is an energetic cathartic, produc- 
ing griping, and sometimes operating with decided harshness, on 
which account it is generally combined with other medicines which 
lessen the severity of its action. The dose is from five to twenty 
grains. 

SciiUcap (Scutellaria Lateriflora). — An indigenous plant, flowering 
in July and August. The whole herb is used. It is a valuable ner- 
vine, tonic, and antispasmodic ; while it gives 
support to the nerves, therefore, it imparts both 
quietness and strength to the whole system, and 
does not, like other nervines, leave the patient 
excited and irritable. It finds its use in the 
treatment of neuralgia, chorea, convulsions, lock- 
jaw, and most other diseases of the nervous 
system. 

Preparations. — Fluid extract, dose, half a 
dram to a dram ; compound fluid extract, dose, 
half a dram to a dram; tincture, foar ounces 
to a pint of diluted alcohol, dose, one to two 
drams; infusion, dose, a wineglassful, three times 
a day; scutellarin, the active principle, dose, two 
to six grains. 



FiQ. 224. 




SCTTLLOAP. 



Seneka (Pohjgala Senega). — An indigenous 
plant, commonly called snake-root^ the root of 
which is used in medicine. It is a stimulating diuretic and expecto- 
rant, and in large doses, an emetic and cathartic. It excites all the 
secretions. It is useful in chronic bronchitis, and in other chronic 
affections of the breathing tubes. 

Preparations. — Fluid extract, dose, twenty to forty drops ; infusion, 
dose, one ounce to an ounce and a half; syrup, four ounces of fluid 
extract to twelve ounces simple syrup, dose, half a dram to a dram. 
The following is a very good expectorant cough preparation : fluid 
extract of seneka, three drams ; fluid extract of squill, half a dram ; 
syrup of tolu, two drams ; paregoric, two drams ; carbonate of ammo- 
nia, twenty grains ; water, four and a half ounces. Mix. Dose, one 
dram. 

Senna {Cassia Acutifolia). — Grows abundantly in Upper Egypt. 
The leaves are the medicinal part. It is a mild, active, and certain 
cathartic, and is much used in combination with other medicines, 



MEDICINES AND THEIR PREPARATIONS. 



649 



particularly epsom salts. The addition of cloves, ginger, cinnamon, 
and other aromatics, removes all its tendency to griping, and makes it 
a safe and gentle, yet active purgative, in most cases, calling for an 
evacuation of the bowels. 

Preparations. — Fluid extract, dose, one to two drams ; fluid ex- 
tract of senna and jalap, dose, half a dram to a dram ; solid extract, 
dose, three to eight grains ; tincture, three ounces to thirteen ounces 
of diluted alcohol, dose, half an ounce to an ounce ; infusion, two 
ounces to a pint of water, dose, half an ounce to an ounce. 

Shrubby Trefoil {Ptelea Trifoliata), — This shrub, which grows in 
the West, is called irafer-ash, and ivingseed. Its bark and root have 
tonic properties, and are used in intermittent and remittent fevers, and 
wherever nature needs a lift in getting up from exhausting complaints. 
The medicine, like other tonics, improves the appetite and digestion. 
Dose of the solid extract, from three to five grains, three or four times 
a day ; of the cold infusion, a tablespoonful, every two or three hours. 

The oleo-resinous principle of the crude bark is called ptelein, and 
is a powerful tonic. Dose, one or two grains, three or four times a 
day. 

Fig. 226. 



Fio. 225. 




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1 



BKUNK CABBAGE. 



BLIPPERY ELM. 



Skunk Cabbag'e (Symplocarpus FoBtidus). — A perennial plant, grow- 
ing in moist places throughout the United States ; sometimes called 
meadow cabbage. The root is stimulant, expectorant, antispasmodic, 
and slightly narcotic. It is given for pulmonary and bronchial affec- 
tions, epilepsy, hysterics, asthma, hooping-cough, and irritable nerves. 

Preparations. — Fluid extract, dose, twenty to eighty drops ; tinc- 
ture, three ounces to a pint of alcohol, dose, half a dram to a dram ; 
infusion, dose, one to two ounces ; syrup, two ounces of fluid extract 
to eight ounces of simple syrup, dose, two to three drams. For 
asthma and cough, and to promote expectoration, and remove tight- 
ness across the chest, the following is a very good compound prepara- 

82 



650 MEDICINES AND THEIR PREPARATIONS. 

lion : one ounce each of the fluid extract of skunk cabbage, lobelia, 
bloodroot, pleurisy root, and ginger, one pint of water, and three pints 
of alcohol. Dose, two to four drams. 

Slippery Elni ( Ulmus Fulva), — The inner bark of this well-known 
tree is nutritive, demulcent, emollient, and slightly expectorant and 
diuretic. It is valuable as a demulcent drink in inflammations of the 
lungs, stomach, bowels, bladder, and kidneys ; also, for coughs, stran- 
gury, dysentery, and the summer complaint of infants. It makes a 
valuable poultice for various purposes. 

Small Spikenard (Aralia Nudicaulis) — This plant grows througTi- 
out the United States, from Canada to the Carolinas, in rocky woods. 
It is called false sarsaparilla and wild sarsaparilla. The root is a 
gentle stimulant, diaphoretic, and alterative. It is used in domestic 
practice, and by some physicians, in rheumatism, syphilis, and cuta- 
neous diseases. The American spikenard, aralia racemosa, resem- 
bles the small spikenard in medical properties. Either of these roots 
is valuable in chronic affections of the lungs and air tubes. 

Soap (Sapo). — Soap is laxative, antacid, and antilithic, and is much 
used in combination with cathartics, to lessen the severity of their 
action. In mesenteric fever, advantage is derived from rubbing the 
tumid belly of children with a strong lather of soap, morning and 
evening ; and few things are more effectual in removing hardened 
feces from the rectum in cases of obstinate costiveness than an injec- 
tion of soap-suds. 

Sodium. — This is a soft white metal. United with oxygen in the 
proportion of one equivalent each, it forms the alkali, soda. The fol- 
lowing are the principal preparations of soda used in medicine : 

Bicarbonate of Soda (Sodcs Bicarbonas). — -This is a white, inodor- 
ous powder, generally called super carbonate of soda. It is antacid, 
antilithic, and slightly diuretic. It is chiefly used in preparing what 
are called soda powders, and in various preparations of medicine, 
when an antacid is required. It is also taken simply dissolved in 
water, for acidity of the stomach. The yeast powders^ now so much 
used, are said to be composed of about two and a half parts of cream 
of tartar, and one part each of corn starch and bicarbonate of soda. 
Housewives may as well make the combination for themselves. 

Borate of Soda ( Sodce Boras) — This is everywhere known by the 
name of borax, it exists naturally formed in several parts of the 
world, and is likewise manufactured. It is a mild refrigerant and 
diuretic ; also an emmenagogue, promoting menstruation, facilitating 
parturition, and favoring the expulsion of the after-birth, by its spe- 
cific influence upon the womb. It has considerable reputation in the 
treatment of urinary diseases, particularly those connected with an 
excess of uric acid. The dose is from twenty to forty grains in solu- 
tion. Combined with rose-water, honey, and various other things, 
according to circumstances, borax makes a valuable wash for inflam- 
matory affections of the mouth and throat, skin diseases, etc. 



MEDICINES AND THEIR PREPARATIONS. 651 

Chloride of Sodium (Sodii Chloridum). — This is the chemical name 
of muriate of soda^ or common salt. In small doses, it is tonic, altera- 
tive, and anthelmintic. It checks bleeding from the lungs, when 
taken in teaspoonful doses. The dose as an alterative is from ten 
to sixty grains. As moderately used in food by most civilized people, 
it promotes digestion and improves the general health. 

Sulphate of Soda (Sodce Sulphas). — This has a very pretty name, 
but it will not sound half as well to thousands of young persons, 
when they are told that it is the well-known g-Iauber^s salts. From 
half an ounce to an ounce of it, dissolved in half a tumblerful of 
water, acts as a cathartic ; a smaller dose, as a laxative and diuretic. 
Its nauseous and bitter taste may be somewhat concealed, by a little 
cream of tartar, or lemon juice, or a few drops of sulphuric acid. 

Sulphite of Soda ( Soda; Sulphis). — This preparation is in the form 
of transparent crystals, and is very soluble in water. In doses of 
sixty grains, this is said to have been used with success in frothy 
vomitings ; it is also well spoken of as a remedy in acute rheuma- 
tism, and as a wash in thrush, and some diseases of the skin. 

Tartrate of Potassa and Soda (SodcB et Potasscc Tartras). — This 
is one of the mildest, and most cooling purgatives among the salts. It 
is known as rochelle salt, and generally agrees well with irritable and 
delicate stomachs. Dose, froju two drams to an ounce, in a tumbler- 
ful of water. The gentle physic called seidlitz poiuders is composed 
of two drams of rochelle salt and two scruples of bicarbonate of soda 
in a blue paper, and thirty-five grains of tartaric acid in a white paper. 
The contents of each paper is dissolved in half a tumbler of water by 
itself; one solution is then poured into the other, and the whole is 
drank during the effervescence. 

Solomon's Seal ( Convalaria Multiflora). — This is one of our own 
perennial plants, and is found in various parts of the country. The 
root is tonic, mucilaginous, and astringent. It acts especially upon 
mucous tissues, and has therefore found its use in chronic dysentery, 
and piles, and in chronic inflammation of the stomach and bowels. 
Dose of the decoction, or infusion, from one to four fluid ounces, three 
or four times a day. Large doses purge and vomit. The decoction, 
applied locally, relieves the inflammation caused by the poison vine. 

Solution of Arsenite of Potassa {Liquor Potassce Arsenitis). — This 
is known under the names of arsenical solution and Fowler'' s solution. 
It is a transparent liquid, having the color, taste, and smell of spirits 
of lavender. It has the general action upon the human body of the 
arsenical preparations. It is the preparation generally resorted to 
when arsenic is given internally, and is used with considerable suc- 
cess in intermittent fever, leprosy, and several other skin diseases, St. 
Vitus's dance, periodical headache, and some other complaints. The 
dose is from three to ten drops, three times a day, given in water ; 
generally, it is better not to go beyond five drops. Sometimes it dis- 
turbs the stomach, and binds the bowels, producing headache, dizzi- 



6o2 MEDICINES AND THEIR PREPARATIONS. 

ness, and confusion of mind. When such effects follow its use, it 
must be laid aside, and a purgative given. After an interval of two 
weeks, it may be resumed in smaller doses. It often requires to be 
used for several months. 

Spiiiiisli Flies ( Cantharis Vesicatoria), — These insects are of a 
beautiful, shining, golden-green color. They attach themselves to 
such trees, in France, Spain, and Italy, as the white poplar, elder, 
privet, and lilach, upon the leaves of which they feed. They make 
their appearance in swarms upon these trees, in May and June, and 
are shaken off in the morning, while torpid with the cold. Internally 
administered, they are a powerful stimulant, exercising a peculiar in- 
fluence over the urinary and genital organs. In large doses, they 
excite violent inflammation of the alimentary canal and urinary or- 
gans, strangury, irritation of the sexual organs, headache, delirium, 
and convulsions ; also painful priapism, vomiting, bloody stools, sali- 
vation, fetid breath, hurried breathing, and difficulty of swallowing. 
They are given internally for chronic gonorrhoea, leucorrhcea, seminal 
weakness, and paralysis of the bladder. Dose of the powder, from 
half a grain to two grains ; of the tincture, from twenty to sixty 
drops. Solution of potassa, given every hour, in thirty-drop doses, 
is a remedy for strangury produced by cantharides. Spanish flies 
are used externally, in the form of blistering plaster ; also in the form 
of tincture, mixed with various solutions, to produce irritation and 
redness of the skin. 

Spearmint [Mentha Viridis). — This has carminative, diuretic, and 
antispasmodic virtues. The warm infusion of it is much employed 
in domestic practice, to produce perspiration, after taking cold, and 
while suffering from feverish symptoms, from various causes. The 
oil of spearmint has similar properties with the herb, and may be 
taken in five to ten drop doses, on sugar. One ounce of the oil of 
spearmint, dissolved in a pint of alcohol, constitutes the essence of 
spearmint. 

Spermaceti ( Cetaceum). — This is a white crystalline substance, ob- 
tained from the head of the spermaceti whale. In household practice, 
it is considerably used for the coughs and colds of children, being 
generally simmered with molasses or loaf sugar. It forms a part of 
several cerates and ointments. 

Spider's Web (Tela AranecB). — The web of the black or brown 
spider, gathered in barns, cellars, etc., is sometimes given in five or 
six-grain doses, in pill form, and it is said with good effect, in periodi- 
cal headache, hysterics, St. Vitus's dance, asthma, and fever and ague. 
It is likewise applied externally to check bleeding. 

Spirit of Xitric Ether (SpirUus jEtheris Nitrici). — The general 
reader will know this article better under the name of sweet spirits 
of nitre. It is diuretic, diaphoretic, antispasmodic, and stimulant, and 
in large doses, a narcotic poison. It is much used in diseases of the 
urinary organs, either alone or combined with sedatives, and other 



MEDICINES AND THEIR PREPARATIONS. 653 

diuretics. Dose, from twenty drops to two fluid drams, to be taken 
in water, three or four times a day. 

Spoill^e (Spong-ia). — When burned, this is used as an alterative in 
scrofula, scrofulous tumors, goitre, and obstinate diseases of the skin. 
It is much employed by homoeopathic physicians, though it has much 
less remedial power than iodine. Dose, one to three drams, mixed 
with honey or syrup. 

Spurred Rye {Secale Cornutum). — This is a diseased product of 
rye, known by the name of ergot. This article has a peculiar effect 
upon the womb, causing it to contract with great energy, when given 
in full doses. It should never be given, however, continuously, for a 
great length of time, as it has been known, when so used, to produce 
dry gangrene, typhus fever, and nervous disorders connected with 
convulsions. Such were its effects in certain provinces of France, in 
consequence of the use of rye bread contaminated with it. It is use- 
ful in excessive uterine hemorrhage, which it arrests by causing the 
womb to contract, and thus to condense its tissue, and close up its 
bleeding vessels. It has also been successful in bleeding from the 
kings. 

Preparations. — Fluid extract, dose, half a dram to a dram ; tinc- 
ture, four ounces to a pint of diluted alcohol, dose, two and a half to 
five drams ; infusion, dose, one to two ounces ; wine, five ounces of 
fluid extract to a pint of sherry wine, dose, two to four drams, in cases 
of labor ; for other purposes, one to two drams. 

Squill (Sail/a Maritima). — A perennial plant growing in countries 
on the Mediterranean. In large doses, it is emetic and purgative ; in 
small doses, expectorant and diuretic. It is used in pulmonary affec- 
tions to increase expectoration, and in dropsical complaints to aug- 
ment the secretions of the kidneys. Dose of the dried root, one to 
five grains, generally to be united with nitre or ipecac. 

Preparations. — Fluid extract, dose, as an expectorant and diuretic, 
two to six drops ; as an emetic, twelve to twenty-four drops ; com- 
pound fluid extract, dose, ten to twenty drops ; tincture, two ounces 
to a pint of diluted alcohol, dose, twenty to forty drops ; syrup, dose, 
a quarter to half a dram. 

Star Grass (Aletris Farinosa). — This plant is found in dry soils 
throughout most parts of the United States, and called unicorn root, 
ague root, and crow corn. The root is an intensely bitter tonic, and 
is used to improve the tone of the stomach, and for flatulent colic and 
hysterics. It is said also to give tone to the female generative organs, 
affording a protection against miscarriage. The Eclectics call it 
one of their best agents in chlorosis, suppressed menstruation, engorge- 
ment and falling of the womb, and painfal menstruation. Dose of the 
powdered root, from five to ten grains, three times a day. 

Preparations. — Fluid extract, dose, ten to thirty drops ; tincture, 
two ounces to a pint of diluted alcohol, dose half a dram to a dram ; 
infusion, two drams to a pint of water, dose, one to two ounces ; 



654 



MEDICINES AND THEIR PREPARATIONS. 



syrup, dose, one to two drams ; aletridin, the active principle, dose, 
one to three grains. 

St. Ig'iiatius's Bean (Faba Sandi Ignatii). — The seeds are the part 
used, and are the product of the Ignatia Amara^ — a tree of middle size, 
growing in the Philippine Islands, and is a species of the strichnos. 
These seeds possess a large amount of strychnine, and consequently, 
in medicinal doses, are a powerful nervine tonic, and are used for im- 
proving the digestive functions, and for rousing and strengthening 
the whole system when prostrated by nervous complaints. 

Preparations. — Fluid extract, dose, five to ten drops ; solid extract, 
dose, half a grain to a grain and a half. 

Storax (Styrax Officinale). — This is the hardened juice of the 
storax, a native of the countries along the Mediterranean. It is a 
stimulant and expectorant, and is used for chronic bronchitis, laryn- 
gitis, and cough. The liquid storax is sometimes employed instead 
of copaiva in gonorrhoea and gleet. The dose is from ten to twenty 
grains. Storax is a constituent in the compound tincture of benzoin. 



Fig. 227 



Fig. 228. 





STAR GRASS. 



BTRAMONITTM. 



Stramonium (Datura Stramonium). — This annual plant is most 
known in this country by the name of Jamestoivn weed; in England, 
by that of thornapple. The leaves and seeds are medicinal. Stramo- 
nium is a powerful narcotic; it is also antispasmodic, anodyne, and 
sedative. It is used in various nervous affections, as chorea, epilepsy, 
palsy, tetanus, and mania. It is much used for relieving acute pains, 
etc. Taken in large doses, it is a powerful poison. 

Preparations. — Fluid extract, dose, five to twenty drops ; solid 
extract, dose, half a grain to a grain ; tincture, two ounces to a pint 
of alcohol, dose, half a dram to a dram and a half, and to be gradu- 
ally increased. 

Sulphur. — This is considerably used in medicine, being laxative, 
diaphoretic, and resolvent. It is chiefly used for piles, chronic rheu- 
matism, gout, asthma, and those affections of the breathing organs 



MEDICINES AND THEIR PREPARATIONS. 655 

not attended with acute inflammation. Externally and internally, it 
is much employed in skin diseases, particularly the itch, for which it 
is a specific. In these affections, it is frequently applied in the form 
of sulphur baths. The dose of sulphur is from one to three drams, 
mixed with syrup, molasses, or milk. When sublimed, this article is 
called flowers of sulphur^ which is the form in which it is chiefly used 
in medicine. 

Sumacli {Rhus Glahrum). — Found in almost all parts of the United 
States, in old neglected fields, and by the side of fences. The bark 
and berries are astringent, tonic, antiseptic, and diuretic, and are used 
in diarrhoea, dysentery, gonorrhoea, whites, hectic fever, and scrofula. 
The berries make a valuable gargle in quinsy, and ulcerations of the 
mouth and throat, and also a useful wash for ringworm, tetter, and 
ulcers. The excrescences which grow upon the leaves, have nearly 
as much astringency as galls, and, when pulverized and mixed with 
lard, have a similarly soothing effect upon piles. 

Preparations, — Fluid extract, dose, one to two drams ; tincture, 
four ounces to thirteen ounces of diluted alcohol, dose, half an ounce 
to an ounce. 

Sunflower {Hclianthus Annims). — The seeds and the leaves of this 
plant are expectorant and diuretic, and are useful in several pulmon- 
ary affections. The seeds yield a fixed oil, in which their medicinal 
virtues are chiefly found. In doses of ten or twenty drops, this oil 
acts favorably upon inflamed mucous surfaces, and in doses three 
times as large, it greatly augments the flow of urine. 

Swamp Dogwood (Cornns Sericea)* — This is found in damp places, 
and along the banks of rivers, in various parts of our country, and is 
known as red ozier, red willovj^ and rose willow. The bark is tonic, 
stimulant, and astringent, and has been used for similar purposes with 
dogwood bark ; well spoken of, also, for dyspepsia, diarrhoea, malig- 
nant fevers, and as an external application to foul and ill-conditioned 
ulcers. Dose of the powdered bark, from twenty to sixty grains ; of 
the infusion, from two to four fluid ounces. 

Swamp Milkweed (Asclepias Incarnata). — This is a native of the 
United States, and bears red flowers from June to August. It has 
the name of white Indian hemp. The root is emetic, cathartic, and 
diuretic, and is useful in asthma, bronchitis, rheumatism, syphilis, and 
worms. 

Preparations, — Fluid extract, dose, twenty to forty drops ; solid 
extract, dose, three to five grains ; tincture, two ounces to a pint of 
diluted alcohol, dose, one and a half to three drams ; infusion, dose, 
three to six drams ; syrup, four ounces fluid extract to twelve ounces 
simple syrup, dose, half a dram to a dram and a half. 

Sweet Fern (Comptonia Asplenifolia). — This shrub, growing in 
stony pastures in New England and Virginia, is tonic, astringent, 
alterative, and aromatic, and is used in diarrhoea, dysentery, cholera 
infantum, rheumatism, and debility after fevers. Dose of the decoc- 
tion, from one to four fluid ounces, three or four times a day. 



G.j6 medicines and their preparations. 

Sweet Flag (Acorus Calamus). — Found in damp places, in most 
parts of the world. The root is stimulant, tonic, and aromatic; use- 
ful in wind colic, weakened conditions of the stomach, and dyspepsia. 
Dose of the root, from twenty to sixty grains ; of the infusion, from 
two to four fluid ounces. 

Sweet Gum (Liquidamber Styraciflua). — This tree grows in the 
Middle and Southern States. Being wounded, it yields a yellowish- 
white, honey-like balsam, which hardens into a gum. This, melted 
with equal parts of lard or tallow, forms an ointment which is used 
in some parts of the country for piles, ringworm of the scalp, fever 
sores, and other complaints. Used internally, it has very nearly the 
same effects with storax. 

Tag; Alder (Alnus Rubra). — This shrub grows in swamps and other 
damp places, in northern United States. The bark is alterative, 
emetic, and astringent. It is used in scrofula, secondary syphilis, 
herpes, impetigo, and other skin diseases. 

Preparations. — Fluid extract, dose, one to two drams; infusion, two 
ounces to a pint of water, dose, one to two ounces ; alnuin, the active 
principle, dose, one to three grains. 

Tansy (Tanacetum Vulg-are). — Tansy is a perennial herb, having 
tonic, emmenagogue, and diaphoretic properties ; the cold infusion 
being tonic, and useful in dyspepsia, wind in the stomach, jaundice, 
and worms ; the warm infusion, diaphoretic and emmenagogue. Dose 
of the infusion, from one to four fluid ounces, two or three times a 
day. 

Tar (Pix Liquida). — The medicinal qualities of tar are like those of 
turpentine, and it is sometimes used in old chronic coughs and bron- 
chitis. The vapor of boiling tar was once thought to be very service- 
able in bronchial diseases, when inhaled. Doubtless it is useful in 
some cases, but its virtues have been extolled above their merits. In 
the form of ointment, it has real efiicacy in scald head and tetter. 

Tliimbleweed (Rudbeckia Laciniata). — The whole of this herb is 
balsamic, diuretic, and tonic, and, in the form of decoction, used 
freely, is said to have been found useful in some urinary complaints, 
as Bright's disease, strangury, etc. 

Tobacco (Nicotiana Tabacum). — The leaves of tobacco are acrid, 
narcotic, and poisonous, and are chiefly used in the form of ointment, 
in skin diseases, etc. Its poisonous qualities, however, render it dan- 
gerous when much used, even externally. 

Trailing Arbutus (Epigcea Repens). — This grows in sandy woods, 
and rocky soils, its flowers appearing in early spring, and exhaling a 
spicy fragrance. The leaves are diuretic and astringent, and are very 
useful in gravel, and most diseases of the urinary organs, being re- 
garded in some cases superior to Uva ursi and buchu. 

Preparations. — Fluid extract, dose, one to two drams ; infusion, 
dose, two to four ounces. 



MEDICINES AND THEIR PREPARATIONS. 657 

Tapioca (Janipha Manihot). — This plant grows in the West Indies 
and Brazil. It is cultivated chiefly on account of the root, which is 
largely used as an article of food, particularly for the sick, or rather, 
for those recovering from sickness. The starch which it contains is 
separated by washing, scraping, grating, and grinding, and is in the 
form of hard, white, rough grains. It is prepared for use by boiling ; 
and, in debility and low forms of disease, may have the addition of 
wine, nutmeg, or other aromatics. 

Tulip Tree (Liriodendron TuHpifera). — This is a large and elegant 
tree growing in many parts of the country, and called poplar and white 
poplar. The bark of the root is aromatic, stimulant, and tonic, and 
in warm infusion, diaphoretic. It is used in fever and ague, chronic 
rheumatism, and chronic diseases of the stomach and bowels. Dose 
of the powdered bark, from a scruple to two drams ; of the infusion, 
from one to two fluid ounces. 

Turkey Corn {Corydalis Formosa). — This perennial plant is called 
wild-turkey pea, and stag-g-er-weed, and grows in rich soils in the 
Southern and Western States. The tuber, which is the medicinal 
part, should only be collected while the plant is in flower. It is tonic, 
diuretic, and alterative. It is much valued as a remedy in syphilis 
and scrofula. 

Preparations. — Fluid extract, dose, ten to forty drops ; tincture, 
three ounces to a pint of diluted alcohol, dose, half a dram to two 
drams ; corydalin, the active principle, dose, half a grain to a grain. 
A valuable alterative for syphilis is made by uniting eight grains of 
corydalin with ten grains of hydrastin, and dividing into twelve pow- 
ders. Dose, one powder, three or four times a day. 

Turmeric ( Curcuma Longa). — This is a native of the East Indies 
and Cochin China. The root is a stimulant aromatic and tonic, some- 
what like ginger, employed in debilitated states of the stomach, etc. 

Preparations. — Fluid extract, dose, two to three drams ; tincture, 
two ounces to twelve ounces of diluted alcohol, dose, one and a half 
to two ounces ; infusion, dose, two to four ounces. 

Valerian ( Valeriana Officinalis). — This is a European plant, flow- 
ering in June or July. The root is tonic, nervine, and antispasmodic, 
and is much used in cases of irregular nervous action, particularly 
morbid nervous vigilance, or hypochondria, epilepsy, lowness of spirits, 
and nervous headache. 

Preparations. — Fluid extract, dose, half a dram to a dram and a 
half; solid extract, dose three to ten grains; tincture, four ounces to 
a pint of diluted alcohol, dose, two to four drams ; infusion, hsilf an 
ounce to a pint of water, dose, two to four ounces ; syrup, four ounces 
of fluid extract to a pint of simple syrup, dose, two to four drams. 

Vervain ( Verbena Hastata). — A perennial plant, common in the 
United States. The root is tonic, emetic, expectorant, and sudorific. 
It is used in intermittent fevers, colds, and obstructed menstruation, 
in the form of warm infusion. The cold infusion is a good tonic in 

83 



658 



MEDICINES AND THEIR PREPARATIONS. 



loss of appetite, debility, etc. Dose of the powdered root, one or two 
scruples ; of the infusion, from two to four ounces, three or four times 
a day. 

Vinegar (Acetum). — This is refrigerant, diuretic, astringent, and 
tonic ; used in fevers and inflammatory complaints, likewise in scurvy 
and typhus, as an antiseptic. It has been found useful in dysentery 
and scarlet fever, saturated with common salt. Externally, it is ap- 
plied to bruises, inflammations, sprains, and swellings. It sometimes 
has a good effect as a gargle in putrid sore throat, etc., and as a cool- 
ing wash in headache during fevers. 



Fig. 229. 



Fig. 230. 





VXRGINIA S>'AKE-KOOT. 



Fig. 231. 



Virginia Snake-root (Aristolochia Serpentaria). — This is a peren- 
nial herb of the Middle and Southern States. The root is stimulant^ 
tonic, and diaphoretic. It is used in typhoid fevers, when the sys- 
tem needs support, but cannot bear active stimulation. 
Combined with peruvian bark, it is also used in inter- 
mittent fevers. The cold infusion is employed in some 
forms of dyspepsia ; likewise as a gargle in malignant 
sore throat. 

Preparations. — Fluid extract, dose, one quarter to 
half a dram ; tincture, three ounces to a pint of diluted 
alcohol, dose, one to two drams ; infusion, half an ounce 
to a pint of water, dose, one to two ounces, in low forms 
of fever. The following is a good compound tincture : 
half an ounce each of fluid extract of snake-root, fluid 
extract of ipecac, fluid extract of saffron, fluid extract 
of ladies' slipper, together with half an ounce of cam- 
phor, and one and a half pints of diluted alcohol ; dose, 
a dram to a dram and a half. 




HOBKHOUND. 



Water Horehound. — This article has been described 
under Bugle Weed, but the cut was forgotten. See Bugle Weed 
(Lycopus Virginicus). 



MEDICmES AND THEIR PREPARATIONS. 659 

Water Pepper (Polygonum Punciatum). — This annual plant is called 
smart-weed^ and grows throughout our country, in low grounds, and 
along ditches and brooks. It has a pungent, biting taste, and is 
stimulant, diuretic, emmenagogue, antiseptic, and vesicant. It is used 
in coughs, colds, gravel, and womb complaints. 

Preparations. — Fluid extract, dose, ten to sixty drops; solid extract, 
dose, two to three grains ; tincture, four ounces to a pint of diluted 
alcohol, dose, half a dram to two drams ; infusion, half an ounce to a 
pint of water, dose, half an ounce to an ounce. 

Wrtlioo (Euonijmus Atropurpureiis). — A small shrub growing in 
woods in many parts of the United States. The bark of the root is 
a bitter tonic, laxative, alterative, diuretic, and expectorant, and is 
advantageously used in pulmonary affections, dropsy, constipation, 
torpidity of the liver, dyspepsia, and intermittent fevers. 

Preparations. — Fluid extract, dose, one to two drams; tincture, 
four ounces to twelve ounces of diluted alcohol, dose, half an ounce 
to an ounce. 

Wa\, — The yellow and white wax are chiefly used as ingredients 
of plasters and ointments. 

White Hellebore ( Veratrum Album). — This is an European peren- 
nial plant, the root of which is a violent emetic and purgative, and in 
large doses is poisonous ; not often used, except externally, in the 
form of ointment or decoction, for the cure of itch, and some other 
skin diseases. 

White Oak (Quercus Alba). — The inner bark of the white oak is 
astringent, tonic, and antiseptic, and has been used in intermittent 
feyer, chronic diarrhoea, chronic mucous discharges, and passive hem- 
orrhages. As a wash, applied externally, it sometimes arrests night- 
sweats, and as an astringent gargle and injection, its use is common 
for relaxed palate, spongy gums, leucorrhoea, falling of the bowel, etc. 

Preparations. — Fluid extract, dose, half a dram to a dram; solid 
extract, dose, ten to twenty grains ; tincture, two ounces to a pint of 
diluted alcohol, dose, half an ounce to an ounce. 

AVhite Pond Lily (Ni/mphasa Odorata). — This grows in ponds and 
marshes in many parts of our country. The root is demulcent, ano- 
dyne, astringent and alterative; used in dysentery, diarrhoea, gonor- 
rhoea, whites, and scrofula. An infusion is sometimes used as a 
gargle in ulcers of the mouth and throat, and as an injection in leu- 
corrhoea. Dose of the infusion, from two to four fluid ounces. 

Wild Cherry (Prunus Viginiana). — This tree grows extensively in 
the American forests, flourishing where the soil is fertile, and the cli- 
mate temperate. The inner bark is tonic and stimulant to the diges- 
tive organs, and sedative to the nerves and the circulation. It is much 
used in consumption, scrofula, and dyspepsia. 

Preparations. — Fluid extract, dose, two to four drams ; compound 
fluid extract, dose, half a dram to two drams; infusion, half an ounce 



660 



MEDICINES AND THEIR PREPARATIONS. 



to a pint of water, dose, two ounces ; syrup, three ounces of fluid 
extract to thirteen ounces of simple syrup, dose, two drams to an 
ounce. 

Wild Cucumber (Momordica Elaterium), — This, sometimes called 
squirting- cucumber, is a native of the south of Europe, and is culti- 
vated in Great Britain. It is a powerful hydragogue cathartic, and 
in large doses, causes nausea and vomiting. On account of the 
watery stools it produces, it is much used in dropsical complaints, 
though the severity of its action forbids its being used alone. Dose, 
a quarter to half a grain, repeated every hour till it operates ; of elate- 
rin, from a sixteenth to a twentieth of a grain, given in solution. 

Wild Ginger (Asarum Canadense). — This is known by the names 
of coW S'foot and Canada snake-root, and is common in all parts of 
the country. The root is tonic, stimulant, aromatic, expectorant, and 
diaphoretic. It is used in pains of the stomach, colic, etc. Dose of 
the powder, half a dram ; of the tincture, half a dram to two drams. 



Fio. 232. 



Fig. 233. 



U" ^^'^'^ 


- ~~1^ 


\^<^F 


, - 




7^ 




^ 


^l^^j^ 




0j^ 






WILD IlfDIGO. 



WITCH HAZEL. 



Wild Indigo (Baptisia Tinctoria). — This perennial shrub is found 
in most parts of the country. The bark of the root is purgative, 
emetic, stimulant, astringent, and antiseptic. It is chiefly used for its 
antiseptic properties. For external use, it is valuable as a wash or 
gargle for various ulcers, mercurial sore mouth, and scrofulous and 
syphilitic ophthalmia. 

Preparations, — Fluid extract, dose, a quarter to half a dram ; tinc- 
ture, two ounces to a pint of diluted alcohol, dose, two to four drams ; 
infusion, dose, half an ounce ; baptisin, the active principle, a quarter 
to half a grain ; gargle, four ounces of fluid extract to twelve ounces 
of w^ater, to be used as occasion requires. 

Wild Yam (Dioscorea Villosa). — A perennial vine, found mostly 
at the South. The root is antispasmodic, and is successfully used in 
bilious colic. It is said to bring relief in the most violent cases of 
this complaint. It allays nausea and spasms during pregnancy. It is 
given in the form of decoction, two or three fluid ounces every thirty 



MEDICINE^ AND THEIR PREPARATIONS. 



661 



or ferty minutes. Dose of the tincture, from a quarter of a dram to 
a dram ; of dioscorein, the active principle, one to four grains. 

Willow (Silex Alba). — The willow is common in Europe and 
America. Its bark is tonic and astringent ; and is used, occasionally, 
as a substitute for peruvian bark, in intermittent fever. It is also 
employed in the treatment of chronic diarrhoea and dysentery. Dose 
of the powdered bark, one dram ; of the decoction, one to two fluid 
ounces. Salicin, the active principle, is given, sometimes, in place of 
quinine ; dose, from two to ten grains. 

Wmter2:reeii (GauUheria Procumhens). — This evergreen grows in 
mountainous, barren regions, throughout our country. The leaves are 
an agreeable stimulant, aromatic, and astringent. Used for chronic 
diarrhoea, and as an emmenagogue. The oil and essence are useful 
in flatulent colic ; dose of the oil, from five to ten drops, on sugar ; 
of the essence, thirty to forty drops. Much used to flavor other medi- 
cines. ' 

Witch Hazel (Hamamelis Virginica). — This derives its name from 
its having fruit and flowers together on the same tree. It is found in 
most parts of our country. The bark and leaves are tonic, astringent, 
and sedative. It is used in bleeding from the lungs and stomach, and 
in diarrhoea, dysentery, and excessive mucous discharges. It is also 
used in incipient consumption, and for sore mouth, etc. 

Preparations. — Fluid extract, dose, one to two drams ; infusion, 
dose, four drams ; syrup, four ounces of fluid extract to twelve ounces 
of simple syrup, dose, one to two drams. 



Fio 231. 



Fig. 235. 




WOLFSBAKB. 



WOBMWOO©. 



Wolfsbane {Aconitum Napellus). — This has already been described, 
tinder its other common name, which is Monkshood ; but as the cut 
we had prepared to accompany it was omitted, we give it a place 
here, referring the reader to monkshood for its description. 



662 



MEDICINES AND THEIR PREPARATIONS. 



Woriiiseed (Chenopodium Anthelminticum). — This perennial is called 
Jerusalem oak^ and is found in waste places all over the United States. 
An oil is extracted from the seeds, which, in doses of from four to 
eight drops, morning and evening, for a child, destroys worms. A 
strong infusion of the tops has a similar effect. The remedy should 
be used four or five days, and be followed by a purge. 

Wormwood {Artemisia Absinthium). — The tops and leaves of this 
perennial are tonic and anthelmintic; used in intermittent fever, jaun- 
dice, and worms. It restores the appetite in a weakened state of the 
digestive organs, and is also useful in amenorrhcea. It is excellent 
applied as a tincture, or in the form of fomentation, to bruises, sprains, 
and local inflammations. 

Preparations. — Fluid extract, dose, one third to two thirds of a 
dram ; solid extract, dose, three to five grains ; tincture, two ounces 
to fourteen ounces of diluted alcohol, dose, two to four drams ; syrup, 
two ounces fluid extract to six ounces of simple syrup, dose, one to 
two drams. 

Yarrow [Achillea Millefolium). — A perennial herb, common to the 
Old World and New, and growing in old fields, and along fences. It 
is tonic, astringent, and alterative, and has been used in intermittent 
fever, bleeding from the lungs, excessive menstruation, wind colic, and 
chronic dysentery. Dose of the infusion, a wineglassful, three or four 
times a day. 

Yeast (Cerevisice Fermentum). — Yeast is slightly tonic and stimula- 
ting, and has been used with advantage in typhoid fever ; also in scar- 
let fever, and in all diseases where there is a disposition to putridity. 
The dose is from one to two fluid ounces, every two or three hours. 
It makes an excellent antiseptic poultice, for unhealthy and fetid 
ulcers, especially if combined with powdered slippery elm bark, and 
charcoal. 

Yellow Dock (Rumex Crispus). — The root of this riG.23 
perennial plant is alterative, tonic, diuretic, and deter- 
gent, and is regarded as very valuable in the treatment 
of scrofula, syphilis, leprosy, scurvy, and other skin dis- 
eases. 

Preparations. — Fluid extract, dose, one to two 
drams ; solid extract, dose, four to eight grains ; syrup, 
four ounces of fluid extract to twelve ounces of simple 
syrup, dose, half an ounce to an ounce ; rumin, the 
active principle, dose, two to four grains. 

Yellow Jessamine (Gelseminum Sempervirens). — This 
abounds in the Southern States, where it is cultivated 
as an ornamental vine. The root is a powerful febri- 
fuge, narcotic, and relaxant, controlling and subduing 
fever, quieting nervous irritability and excitement, 
equalizing the circulation, promoting perspiration, and rectifying the 
secretions. It is much used by the Eclectics of the Western States, 
but the general judgment of the profession is, that it is too powerful 




YELLOW DOCK. 



MEDICINES AND THEIR PREPARATIONS. 663 

a remedy to be safe. My own opinion is, that the American hellebore 
is equally effective with the yellow jessamine, and that its general use 
involves far less danger. 

Preparations. — Fluid extract, dose, two to twenty drops ; tincture, 
four ounces to a pint of alcohol, dose, fifteen to sixty drops, and in- 
crease ; gelseminin, the active principle, dose, half a grain to a grain 
and a half. 

Yellow Ladies' Slipper ( Cypripedium Pubescens). — This perennial 
plant is called American valerian^ nerve root, etc. The fibrous roots 
are tonic, nervine, antispasmodic, and diaphoretic, and are used in 
nervous headache, nervous excitability, hysterics, neuralgia, and St. 
Virus's dance. Dose of the powder, from ten to thirty grains. 

Preparations. — Fluid extract, dose, half a dram to a dram ; solid 
extract, dose, five to fifteen grains ; tincture, two ounces to a pint of 
diluted alcohol, dose, half an ounce to an ounce ; syrup, four ounces 
of riuid extract to fourteen ounces of simple syrup, dose, two to four 
drams ;' cypripedin, the active principle, dose, two to four grains. 

Yellow Parilla {Menispermum Canadense). — This is a perennial 
plant, growing in woods, and near streams, throughout the country. 
The root has the properties of a tonic, laxative, alterative, and diu- 
retic. It is valued in the treatment of scrofula, syphilis, skin diseases, 
gout, rheumatism, dyspepsia, general debility, and chronic inflamma- 
tion of the stomach and bowels. Dose of the decoction, from two to 
four fluid ounces, three times a day ; of the solid extract, from two to 
four grains. 

Zinc. — Several preparations of this metal are used in medicine, as 
follows : 

Acetate of Zinc. — This is used as an external remedy only, gener- 
ally as an astringent wash for inflammations of the eye, and as an 
injection in gonorrhoea, but only after the acute stage of these diseases 
has past. The strength of these solutions generally should be one or 
two grains to a fluid ounce of soft water. 

Cliloride of Zinc (Zinci Chloridum). — This is a powerful escharotic, 
and is employed as an external application to cancers and obstinate 
ulcers. A weak solution of it is occasionally employed in old chronic 
gleet, also in whites, and purulent discharge from the neck of the 
womb. 

Iodide of Zinc (Zinci lodidum). — This is in the form of white 
needles, and is tonic and astringent. It is not much used, except 
externally, being applied in a solution of twenty grains to a fluid 
ounce of water, to enlarged tonsils, by means of a camel's-hair pencil, 
or a piece of sponge tied to the end of a stick. 

Oxide of Zinc (Zinci Oxidum). — This is an inodorous, white pow- 
der, insoluble in water and alcohol. It is tonic and antispasmodic, 
and is given in chorea, epilepsy, hooping-cough, and other similar dis- 
eases ; but it is more especially employed to arrest the night-sweats 
of consumption, for which purpose, we have at present no other 



664 MEDICINES AND THEIR PREPARATIONS. 

article of equal efficacy. It is sprinkled externally upon excoriated 
surfaces, and is used in ointments. Dose from two to eight grains, in 
the form of pill. 

Precipitated Carbonate of Zinc (Zinci Carhonas Prcecipitatas). — 
This is employed for the same purpose as prepared calamine, being 
adapted only to external use. 

Prepared Calamine ( Calamina Prcsparata). — This is in the form 
of a pinkish or flesh-colored powder, of an earthy appearance. It is 
employed only as an external application, being dusted on excoria- 
tions and superficial ulcerations, as a mild astringent. It should be a 
very fine powder. 

Sulphate of Zinc ( Zinci Sulphas). — This is a colorless, transparent 
salt, crystallizing usually in small, four-sided prisms. It is tonic and 
astringent, and in large doses, a prompt emetic. Used as a tonic in 
cases of debility attended with irritation. In obstinate intermittents, it 
is sometimes conjoined with sulphate of quinia; it is chiefly employed, 
however, in such spasmodic diseases as epilepsy, chorea, and hooping- 
cough. As an astringent, it is used externally, being applied in solu- 
tion to bleeding surfaces, as a wash in ophthalmia, and as an injection 
in whites and chronic gonorrhoea. 

Valerianate of Zinc (Zinci Valerianas). — This is in white, pearly 
scales, with a faint odor of valerianic acid. It is tonic and antispas- 
modic, and is used in the various nervous afl*ections which accompany 
chlorosis. Dose, one or two grains, several times a day, in the form 
of pill. 

Preparations. Pharmacy. 

# 

The preparation of medicines for use, constitutes the art of phar- 
macy. It is the peculiar business of the apothecary. It will not be 
necessary in these pages to describe his art, in all particulars, but 
merely as many of the preparations which it is his duty to prepare as 
are really needed in the treatment of disease. In doing this, I shall 
classify the preparations alphabetically, and begin with 

Cerates. 

These substances have a degree of hardness midway between oint- 
ments and plasters. They may be spread upon leather or linen, with- 
out the use of heat, and they do not melt and run when applied to the 
skin. They are made of wax, or spermaceti, combined with lard or 
oil. The articles are melted together by a very gentle heat, and dur- 
ing the process of cooling, the whole should be well stirred. 

Calamine Cerate. — Prepared calamine and yellow wax, each three 
ounces ; lard, one pound. Melt the lard and wax together. When 
the mixture begins to thicken, on cooling, gradually stir in the cala- 
mine. 



MEDICINES AND THEIR PREPARATIONS. 665 

This is called Turner's cerate^ and is useful for burns, excoriations, 
superficial ulcers, and sores. 

Goulard's Cerate. — Take of solution of subacetate of lead, two 
fluid ounces and a half; white wax, four ounces; olive oil, nine fluid 
ounces ; camphor, half a dram. Mix the wax, previously melted, with 
eight fluid ounces of the oil ; remove from the fire, and when the mix- 
ture begins to thicken, gradually pour in the solution of subacetate of 
lead, stirring constantly, with a wooden spatula, till it becomes cool. 
Then add the camphor, dissolved in the remainder of the oil. 

This is the cerate of subacetate of lead^ and is used for excoriations, 
inflamed burns, scalds, and chilblains, and for eruptions of the skin. 
Excellent for blistered surfaces, indisposed to heal. 

Half an ounce of this preparation united with half an ounce of 
simple cerate, and one dram each of calomel and powdered opium, 
makes a very valuable remedy for various eruptions of the skin, of a 
local nature. 

Resin Cerate, — Take of resin, five ounces ; lard, eight ounces ; 
yellow wax, two ounces. Melt together with a gentle heat, and stir 
till cook 

This is known as basilicon ointment^ and is used as a gentle stimu- 
lant to blistered surfaces, indolent ulcers, burns, scalds, and chilblains. 

Compound-Resin Cerate. — Take of resin, suet, and yellow wax, 
each a pound ; turpentine, half a pound ; flax-seed oil, half a pint. 
Melt together, strain through linen, and stir till cool. 

This, under the name of Deshler's salve, is popularly used for simi- 
lar purposes with the resin cerate. 

Savine Cerate. — Take powdered savine, two ounces ; resin cerate, 
a pound. Mix the savine with the cerate, previously softened. 
Used as a dressing for perpetual blisters. 

Simple Cerate. — Lard, eight ounces ; white wax, four ounces. Melt 
together, and stir till cool. 

Used for dressing blisters, wounds, etc., where it is desirable simply 
to preserve the moisture of the part, and to exclude the air. 

Spanish Flies Cerate, known as blistering' plaster. Take finely 
powdered Spanish flies, a pound ; yellow wax and resin, each seven 
ounces; lard, ten ounces. To the wax, resin, and lard, previously 
melted together and strained, add the Spanish flies, and, by means of 
the most gentle heat, keep the mixture in a fluid state for half an 
hour, stirring occasionally, then remove the heat, and stir till cool. 

This can be easily spread without the aid of heat, and is used for 
the purpose of drawing blisters. It is now, however, superseded in a 
great degree by various preparations, composed for the most part of 
cantharidin, either dissolved in oil, and applied to the skin by means 
of a piece of paper saturated with it, or incorporated with wax, and 
spread in a very thin layer upon fine waxed cloth, silk, or paper, con- 
stituting the blistering cloth, blistering paper, etc. 

84 



666 MEDICINES AND THEIR PREPAKATIONS. 



Confections, Conserves, and Electuaries. 

These are soft solids, in which medicinal articles are incorporated 
with sugar, syrup, honey, or some other sacharine matter, for the pur- 
pose both of preserving the mass, and of rendering the medicine more 
palatable and convenient for use. 

Aromatic Confection. — Take of aromatic powder, five and a half 
ounces ; powdered saffron, half an ounce ; syrup of orange peel, six 
ounces; clarified honey, two ounces. Rub the aromatic powder with 
the saffron ; then add the syrup and honey, and beat the whole to- 
gether, in a mortar, till they are thoroughly mixed. 

Given in debilitated states of the stomach, as a yehicle for other 
medicines. Dose, from ten grains to a dram. 

Compound Confection of Catechu. ^ Take of compound powder of 
catechu, five ounces : simple syrup, five fluid ounces. Add the syrup 
gradually to the powder, and mix them well. 

To be given in diarrhoea and chronic dysentery, in the dose of half 
a dram to a dram. 

Confection of Senna, otherwise called lenitive electuary. Take of 
senna, eight ounces ; coriander seeds, four ounces ; bruised liquorice 
root, three ounces ; figs, a pound ; pulp of prunes, pulp of tamarinds, 
pulp of purging cassia, each, half a pound ; refined sugar, two pounds 
and a half; water, four pints. Rub the senna and coriander together, 
and separate ten ounces of the powder with a sieve. Boil the residue 
with the liquorice root and figs, in the water, to one half; then press 
out the liquor, and strain. Evaporate the strained liquor, by the most 
gentle heat, to a pint and a half; then add the sugar and form a 
syrup. Lastly, rub the pulps with the syrup, added gradually, and, 
having thrown in the sifted powder, beat all together till well mixed. 

This is a pleasant and admirable laxative, being well adapted to 
the habitual costiveness of pregnant women, and those affected with 
piles ; for this latter purpose, it is still better combined with cream of 
tartar and sulphur, as described in No. 6 of the prescriptions, at the 
end of the book. 

Decoctions. 

• These are solutions of vegetable medicines, obtained by boiling 
them in water. They differ from infusions, in being subjected to 
a greater degree of heat, the water during their preparation being 
kept up to the boiling point. The process should be conducted in a 
covered vessel, and the boiling must not be continued for a very long 
time. Medicines, whose active principle is volatile, are not proper for 
decoctions, the active principle being driven off by heat, and lost. 

The usual proportion of vegetable substances used in making de- 
coctions is one ounce to a pint of water, and the dose of the decoc- 
tion, from one to four ounces. 



MEDICINES AND THEIR PREPARATIONS. 667 



Essences. 

These are generally prepared by dissolving one ounce of the essen- 
tial oils of plants in one pint of alcohol. The oils of lemon, pepper- 
mint, sassafras, etc., are made in this way, and their properties, of 
course, are similar to the oils from which they are prepared. They 
are generally taken in a little sweetened water, in doses of ten drops 
to a teaspoonful. 

Extracts. 

These are soft solids, obtained by evaporating the tinctures, or 
solutions, of vegetable substances. The active principles of dried 
vegetables can only be extracted by some liquid ; this, for preparing 
extracts, is either water, or alcohol, or a mixture of the two. Those 
obtained by the use of water are called aqueous, or watery extracts ; 
those by means of alcohol, alcoholic extracts ; and those by both alco- 
hol and water, hydro-alcoholic extracts. 

Extracts are generally prepared on a large scale, by persons who 
make a business of it. Like other articles, many of these prepara- 
tions get into the market which are inferior in quality, and even 
worthless. Without disparaging the preparations of other manufac- 
turers, I would mention those prepared by the large manufacturing 
house of Tildeii & Co., at New Lebanon, New York, as worthy of 
public confidence. Most of their solid extracts, with the proper doses, 
are mentioned in previous pages, under the several articles from which 
they are made. 

Fluid Extracts. 

These are concentrations, into a small bulk, in liquid form, of the 
active principles of medicinal substances. They are a valuable class 
of remedies, being in some cases preferable to tinctures, having less 
alcohol ; and better than extracts or decoctions, because not so often 
injured by heat in their preparation, and not requiring to be taken in 
large doses. Great skill is required in their preparation, and they 
should always be obtained from those who have the reputation of 
making reliable articles. None that I am acquainted with, better 
deserve confidence than those of Tilden & Co. 

Fomentations. 

Fomentation is a sort of partial or local hot bath, and consists 
either in the application of cloths dipped in hot water, or some hot 
medicated decoction, and applied' to the affecjted part, or, of bitter or 
anodyne herbs steeped in vinegar or water, and then, while hot, en- 
closed in a muslin bag, and laid upon the diseased place. In either 
case, whether the cloths wet in a decoction of the herbs, or the herbs 
themselves, slightly steeped, be applied in a bag, the application should 



G6S MEDICINES AND THEIR PREPARATIONS. 

be as hot as can be borne, and not so moist as to wet the bed or 
clothes of the patient. 

Fomentations act by their warmth and moisture chiefly ; and 
slightly, in some cases, by their medicinal virtues. Their object is 
to lessen pain and inflammation, by relaxing the parts, and relieving 
tension and spasm. They may be prepared from equal parts of hops, 
tansy, and wormwood, or from equal parts of hops, lobelia, and stra- 
monium, etc., etc. 

Infusions. 

For a description of simple infusions, see page 588. Those made 
of one article only are sufl[iciently referred to in previous pages. It 
will only be necessary here to insert such compound infusions as are 
deemed important. 

Compound Infusion of Catechu. — Take of powdered catechu, half 
an ounce ; bruised cinnamon, a dram ; boiling water, a pint ; macer- 
ate for an hour in a covered vessel, and strain. An elegant mode of 
administering catechu. Dose, from one to three fluid ounces, three or 
four times a day. 

Compound Infusion of Gentian. — Take of bruised gentian, half an 
ounce ; dried orange peel and coriander seeds, bruised, each a dram ; 
diluted alcohol, four fluid ounces ; cold water, twelve fluid ounces. 
First, pour on the diluted alcohol, then, three hours afterward, the 
water. Let the whole stand twelve hours, and strain. An excellent 
form for using gentian. Dose, one fluid ounce, three or four times a 
day. 

Compound Infusion of Geranium. — Take of geranium root, black 
cohosh root, golden seal root, witch-hazel bark, each, in coarse powder, 
one ounce ; boiling water, four pints. Mix, and allow all to stand in 
a covered vessel, two hours, applying a gentle heat ; then strain. Two 
drams of alum may or may not be added. 

Used in chronic diarrhoea and dysentery, in one or two tablespoon- 
ful doses, every two or three hours; also as an injection in gleet, 
whites, falling of the bowel, etc. ; and as a gargle in ulcerations of 
the mouth and throat. 

Compound Infusion of Parsley. — Take of parsley roots and seeds, 
and subcarbonate of iron, each,, two ounces;^ horseradish root, one 
ounce; squill, juniper berries, white mustard seed, mandrake root, 
and queen of the meadow root, each, half an ounce ; coarsely bruise 
these articles, and place them in boiling cider, and expose them, for 
twenty-four hours, to a very gentle heat, in a covered earthen vessel. 
The cider should be sparkling and tart. Let the articles stand in the 
cider. 

Useful in dropsy. Dose, one or two fluid ounces, three or four 
times a day. 

Compound Infusion of Senna. — Take of senna and manna, each, 
one ounce ; jalap, cream of tartar, and caraway seeds, bruised, each, 



MEDICINES AND THEIR PREPARATIONS. 669 

two drams ; boiling water, one pint. Add all the ingredients to the 
water, in a covered vessel, and let them stand twelve hours. Then 
add four ounces of elixir salutis. 

This is a valuable, and not disagreeable, gentle physic for various 
purposes. Dose, from one to four ounces. 

Compound Infusion of Trailing Arbutus. — Take of queen of the 
meadow root, dwarf elder bark, marshmallow root, and trailing arbu- 
tus, each, coarsely bruised, half an ounce ; add to them, one pint 
of boiling water, and one pint of Holland gin, and steep by the fire 
four hours, in a closely covered vessel. Strain, and sweeten with 
honey. 

Excellent for gravel, suppression of urine, scalding of urine, and 
various other disorders of the urinary organs. Dose, from an ounce 
to a wincglassful, with more or less frequency, according to the ur- 
gency of the case. * 

Injections. — Clysters, 

These are preparations to be introduced into the lower bowel by 
means of a syringe. A sufficient number of them are given among 
the recipes at the end of the book. It is not necessary to repeat 
them here. 

Liniments. 

These are liquid preparations, generally a little thicker than water, 
and thinner than oils, intended only to be applied to inflamed, pain- 
ful, or swelled parts. They are designed to soothe, or quiet, or stim- 
ulate, or make red the part to which they are applied ; and are rubbed 
on with the hand, or a piece of flannel or cotton, and frequently in 
connection with heat, by sitting or standing before a fire. 

A large number of liniments are given under the head of recipes 
at the end of the book. To those, I add a few valuable ones here. 

Camphor Liniment. — Take six drams of camphor, and dissolve it 
in one fluid ounce of chloroform, and add to this one fluid ounce of 
olive oil. 

For sprains, neuralgia, rheumatism, etc. 

Compound Camphor Liniment — Take two ounces and a half of 
camphor, a fluid dram of oil of lavender, seventeen fluid ounces of 
alcohol, and three fluid ounces of strong solution of ammonia. Dis- 
solve the camphor and the oil in the alcohol ; then add the ammonia, 
and shake till they are mixed. 

To be used as a rubefacient and anodyne for local pains, particu- 
larly rheumatism. 

Compound Liniment of Ammonia. — Take five fluid ounces of 
strong water of ammonia, two fluid ounces of tincture of camphor, 
and one fluid ounce of spirit of rosemary. Mix th6m well together. 



670 MEDICINES AND THEIR PREPARATIONS. 

This is similar to Dr. Granville's counter-irritant lotion; and is used 
as a prompt and powerful rubefacient, or even vesicatory, in neural- 
gia, rheumatism, gout, spasms, and inflammations. 

Croton Oil Liuimeut. — Take one fluid ounce of croton oil, and 
seven fluid ounces of oil of turpentine. Mix, and shake them well 
together. 

A good rubefacient and pustulating preparation to apply to the 
chest and other parts. 

Liniment of Opium. — Take six ounces of castile soap, an ounce 
and a half of opium, three ounces of camphor, six fluid drams of oil 
of rosemary, and two pints of alcohol. Macerate the soap and opium 
in the spirit for three days ; then filter, and add the oil and camphor, 
and shake briskly. 

This is a useful anodyne and rubefacient liniment for bruises, 
sprains, and pains of a rheumatic and gouty nature. 

Liniment of Spanish Flies. — Take an ounce of powdered Spanish 
flies, and half a pint of oil of turpentine. Mix, and apply gentle heat 
to them, in a covered vessel, for three hours. Then strain. 

Employed with advantage, externally, in the sinking stage of ty- 
phoid fevers. If so powerful as to be in danger of causing blistering, 
it may be weakened by adding flax-seed or olive oil. 

Liniment of Turpentine. — Take half a pint of oil of turpentine, and 
a pound of resin cerate. Melt the cerate, and add the oil to it, — mix- 
ing them well. 

This is a valuable remedy for scalds and burns, and should be 
applied soon after the accident, and be discontinued when the inflam- 
mation excited by the fire is removed. The burned or scalded surface 
should be covered with lint wet with the liniment. 

Opodeldoc. — Take three ounces of white bar soap, sliced, an ounce 
of camphor, a fluid dram each of oil of rosemary and oil of origa- 
num, and a pint of alcohol. Digest the soap in the alcohol by means 
of a gentle heat, until it is dissolved ; then add the camphor and oils, 
and when they are dissolved, pour the whole into broad-mouthed 
vials. 

This is the campliorated soap linhnent^ and is used as an anodyne 
application to sprains, bruises, and painful tumors, etc. 

Medicated Waters. 

Those preparations consisting of water impregnated with some 
medicinal substance are called medicated waters. They are prepared 
from volatile oils by triturating in a mortar a dram of the oil, more 
or less, with a small quantity of carbonate of magnesia, and then very 
gradually pouring on one quart of water, while the trituration is con- 
tinued. At last, the preparation is filtered through paper. The quan- 
tity of oil, magnesia, and water, used for each preparation, is as fol- 
lows ; 



MEDICINES AND THEIR PREPARATIONS. 671 

Oil of bitter almonds, sixteen minims; carbonate of magnesia, a 
dram; water, one quart. 

Oil of cinnamon, half a fluid dram ; carbonate of magnesia, a dram; 
water, one quart. 

Twenty minims of oil of roses, a dram of carbonate of magnesia, 
and one quart of water. 

Oil of fennel, half a fluid dram; carbonate of magnesia, a dram; 
water, a quart. 

Peppermint Water, Spearmint Water, and Pennyroyal Water, are 
all prepared from the same quantities of their several oils, as Cinna- 
mon Water. 

The dose of these waters is half a fluid ounce to two fluid ounces, 
except the bitter almond water, which is one or two fluid drams. 

Caiiiplior AVater. — Take two drams of camphor, forty minims of 
alcohol, four drams of carbonate of magnesia, and one quart of water. 
Rub the. camphor first with the alcohol, afterwards with the carbonate 
of magnesia, and lastly, with the water, gradually added. Then filter 
through paper. 

Medicated Wines. 

Wines are used in making certain preparations, because the alco- 
hol they contain will extract from plants, etc., some medicinal proper- 
ties which water will not, and at the same time is less stimulating 
than the tinctures, etc., made from alcoholic spirits. 

Compound Wine of Conifrey (Restorative Wine Bitters). — Take 
one ounce, each, bruised, of comfrey, Solomon's seal, and spikenard; 
and half an ounce, each, bruised, of chamomile flowers, Colombo, and 
gentian. Cover these with boiling water, and let them stand twenty- 
four hours, in a covered vessel. Then add two quarts of sherry wine. 
Macerate fourteen days, express and strain. 

Valuable in leucorrhoea and other female complaints. Dose, from 
half a fluid ounce to two fluid ounces, three or four times a day. 

Compound Wine of Golden Seal. — Take one dram, each, bruised, 
of golden seal root, tulip tree bark, and bitter root, half a dram of 
pulverized cayenne, and two quarts of sherry wine. Macerate for 
fourteen days, with occasional shaking ; then express and strain. 

This is a pleasant bitter tonic in dyspepsia, etc. Dose, from half a 
fluid ounce to two fluid ounces, three times a day. 

AVine of Ipecacuanha. — Take two ounces of bruised ipecac, and 
one quart of sherry wine. Macerate fourteen days, with occasional 
shaking. Then express and filter through paper. 

This is a valuable emetic preparation, — especially for children. 
Dose, as an emetic, for an adult, one fluid ounce ; as an expectorant, 
from ten to thirty minims; for a child two years old, as an emetic, 
one fluid dram, repeated every fifteen minutes till it operates. 



G72 MEDICINES AND THEIR PREPARATIONS. 



Mixtures. 

These are preparations in which medicinal substances which can- 
not be dissolved in water are suspended in it by means of some viscid 
matter, like sugar, or gum arabic. Their object is to conceal the taste, 
prevent the sickening effect, and make it more easy to take disagreea- 
ble medicines. To make a perfect mixture requires skill. Generally, 
the medicine to be suspended should be triturated in a mortar with 
the sugar, gum arabic, etc., before the water is added. 

Almond Mixture. — Take half an ounce of sweet almonds, half a 
dram of powdered gum arabic, two drams of sugar, and eight fluid 
ounces of water. Soak the almonds in the water, and having removed 
their external coat, beat them with the gum arabic and sugar in a 
mortar, till they are thoroughly mixed ; then rub the mixture, gradu- 
ally adding the water, and lastly, strain. 

This is an agreeable, nutritive demulcent, in bronchial, dysenteric, 
and urinary affections. It must be used freely, the dose being from 
two to eight fluid ounces. 

Chalk Mixture. — Take half an ounce of prepared chalk, two drams 
each of refined sugar and powdered gum arabic, and four fluid ounces 
each of cinnamon-water and water. Rub them together till they are 
thoroughly mixed. 

This is much used in looseness of the bowels, accompanied with 
acidity, particularly among children. If an increase of its astringency 
be required, add laudanum, or kino, or catechu. 

Compound Mixture of Iron. — Take a dram of myrrh, twenty-five 
grains of carbonate of potassa, one scruple of powdered sulphate of 
iron, half a fluid ounce of spirit of lavender, one dram of refined sugar, 
and seven and a half fluid ounces of rose water. Rub the myrrh in 
a mortar, gradually adding the rose water, then mix with these the 
spirit of lavender, sugar, and carbonate of potassa, and lastly, the 
sulphate of iron. Pour the whole into a glass bottle, and keep it 
well stopped. 

This is about the same thing as Griffith^ myrrh mixture^ and is 
considerably used in chlorosis, and other affections requiring the use 
of iron. 

Brandy Mixture. — Take four fluid ounces each of brandy and cin- 
namon water, the yolks of two eggs, half an ounce of refined sugar, 
and three drops of oil of cinnamon. Mix them. 

A useful stimulant and nutritive draught, to be used in the sinking 
stage of low forms of fever. 

Extract of Rhubarb and Potassa (Neutralizing Extract). — Take 
two pounds of the best rhubarb, one pound each of cinnamon and 
golden seal. Grind or coarsely bruise the articles, and mix them ; 
macerate them for two days in one gallon of the best fourth proof 
brandy. Then express the tincture with strong pressure, and add to 



MEDICINES Amy THEIR PREPARATIONS. 673 

it one fluid dram of oil of peppermint, previously dissolved in a little 
alcohol. Break up the compressed residue from the press, and place 
it in a perculator, and gradually run warm water through it, until the 
strength is exhausted. Evaporate this solution to four pints, and 
while the liquor is still hot, dissolve in it two pounds of bicarbonate 
of potassa, and three pounds of refined sugar. Continue the evapo- 
ration, if necessary, until, when added to the tincture first obtained, 
it \nll make a gallon and a half, then mix the two solutions together. 
This is a useful preparation for diarrhoea, dysentery, cholera morbus, 
summer complaints of children, acidity of the stomach, heartburn, etc. 
Dose, one fluid dram. 

Mettaiier's Aperient, — Take one ounce and a half of pulverized 
aloes, four ounces of bicarbonate of soda, two fluid ounces of com- 
pound spirits of lavender, and two quarts of water. Place the whole 
in a jar, or jug, and let them stand fourteen days, shaking well once 
a day. Then pour off" from the dregs. It improves by age. 

This preparation was made by Professor Mettauer, and was held 
in so high esteem by him, that when he sent it to the London Lancet, 
he requested that he might have the credit of compounding it. It is 
one of the best known aperients for costiveness, — particularly w^hen 
connected with bilious dyspepsia. For that class of bilious persons 
who overeat, and have acid stomachs, it has great value. In bilious 
cases, the nitro-muriatic acid, taken before meals (the aperient after 
meals) may be usefully associated with it. In the constipation of 
hysteria and hypochondriasis, the fluid extract of valerian may be 
added to it. Dose, from two drams to two ounces. 

Saline Mixture ( Wliite Liquid Physic). — Take half a pound of 
sulphate of soda, and one and a half pints of water. Mix, and dis- 
solve the soda ; then add two fluid ounces of nitro-muriatic acid, and 
one dram and eight grains of powdered alum. 

Used to allay nausea and vomiting, and as a cooling purgative ; 
also for colic, diseases of the liver, diarrhoea, dysentery, intermittent 
fevers, etc. 

This is one of the remedies of the Eclectic school of physicians, 
and is held by them in high esteem. Dose, a tablespoonful in a gill 
of water, to be repeated every hour or two, until it causes one or two 
evacuations from the bowels. 

Ointments. 

Ointments are composed of fatty substances, about the consistence 
of butter, impregnated with medicine. All gritty matter should be 
excluded from them. To prevent the rancidity to which they are 
liable, a little glycerin is now frequently added. 

Ointment of Acetate of Lead. — Take two ounces of white wax, 
and four ounces of lard ; melt them together, and add two and a half 
drams of finely powdered acetate of lead ; stir constantly till cold. 
This is useful for burns scalds, ulcers, and excoriations. 

85 



674 MEDICINES AND THEIR PREPARATIONS. 

Ointment of Bayberry. — Take half a pound each of tallow, white 
turpentine, and bayberry, and four ounces of olive oil ; melt together 
and strain. 

Good for scrofulous and indolent ulcers. 

Ointment of Belladonnn. — Take a dram of extract of belladonna, 
and an ounce of lard ; mix them. 

A useful anodyne application for painful tumors, neuralgia, etc- 

Ointment of Creosote. — Take half a fluid dram of creosote, and an 
ounce of lard ; mix them. 

A useful application for syphilitic, scrofulous, and cancerous ulcers. 

Compound Ointment of Galls. — Take six drams of finely powdered 
galls, six ounces of lard, and a dram and a half of pulverized opium ; 
rub them together. 

A valuable preparation in irritable piles. 

Ointment of Red Iodide of Mercury. — Take one dram of red iodide 
of mercury, and seven drams of ointment of white wax ; incorporate 
them thoroughly together by trituration in a mortar. 

Used as a dressing for indolent scrofulous ulcers. 

Ointment of IVitrate of Mercury. — Take one ounce of mercury, 
eleven fluid ounces of nitric acid, nine fluid ounces of fresh neats-foot 
oil, three ounces of lard. Dissolve the mercury in the acid, then heat 
the oil and lard together in an earthen vessel to 200° F. ; then add 
the mercurial solution, and stir with a wooden spatula, constantly, as 
long as effervescence continues, and afterward occasionally till the 
ointment stiffens. 

Milder Ointment of Mtrate of Mercury. — Take an ounce of oint- 
ment of nitrate of mercury, and seven ounces of lard ; rub them to- 
gether. 

The first of the above two preparations is the citrine ointment^ and is 
much and advantageously employed as an external application in 
porrigo, impetigo, psoriasis, and pityriasis. It is nearly a specific for 
inflammation of the eyelids connected with the formation of scaly 
matter about the lashes. The second of these two preparations is 
merely a dilution of the first. 

Ointment of Oxide of Zinc. — Take half an ounce of oxide of zinc, 
and three ounces of lard ; rub them together. 

This is a mild astringent application in chronic opthalmia, erup- 
tions of the skin, sore nipples, and other excoriations. 

Ointment of Poison Hemlock. — Take one dram of extract of poison 
hemlock (Tilden & Co.'s preparation), and one ounce of lard; rub 
them together. 

An anodyne application for painful swellings, ulcers, and piles. 

Ointment of Poke. — Take a dram of the extract of poke, and one 
ounce of lard ; mix them. 

For malignant ulcers, scald head, itch, etc. 



IVfEDICIXES AND THEIR PREPARATIONS. 675 

Oiiitmeilt of Sti'amouiiiiil. — Take one dram of the extract of stra- 
monium leaves, and one ounce of lard ; rub the extract with a little 
water till it is uniformly soft, and then with the lard. 

Used as an external application in irritable ulcers, painful piles, and 
skin eruptions. 

Simple Ointiiieut. — Take a pound of white wax, and four pounds 
of lard ; melt them together with a gentle heat, and stir constantly 
till cold. 

Oiutiiieut of Rose Water, — Take a fluid ounce of rose water, two 
fluid ounces of oil of almonds, half an ounce of spermaceti, one dram 
of white wax ; melt together, by means of a water-bath, the oil, sper- 
maceti, and wax ; then add the rose water, and stir the mixture con- 
stantly till cold. 

This is the well known preparation called cold cream^ and is used 
with much advantage for chapped lips and hands, excoriations, etc. 

Spermaceti Ointment. — Take five ounces of spermaceti, fourteen 
of white wax, and a pint of olive oil ; melt them together over a slow 
lire, and stir constantly till cold. 

A mild dressing for blisters, wounds, and excoriated surfaces. 

Tar Ointment. — Take a pound each of tar and suet ; melt the 
suet with a gentle heat, and add the tar to it ; then stir constantly till 
they are cold. 

A useful stimulating application to various scaly and scabby erup- 
tions, particularly leprosy and scald head. 

Ointment of White Hellebore. — Take one ounce of powdered white 
hellebore root, four ounces of lard, and twelve drops of oil of lemons ; 
rub them thoroughly together. 

A useful ointment for the cure of itch. 

Ointment of Wild Indig'O. — Take one pound of powdered wild 
indigo root, moisten it thoroughly with alcohol, and let it stand 
twenty-four hours ; then put it in a percolator, and add alcohol as 
long as the liquid w^hich passes contains the taste of the root. Distil 
the alcohol from this filtered tincture until half a gallon of tincture is 
obtained. Melt one pound of fresh butter, without salt, add the 
above tincture, and carefully evaporate the rest of the alcohol ; stir 
constantly till cold, after the alcohol has nearly passed off. 

This is one of the preparations of the Eclectics, and is a cleansing, 
detergent, antiseptic, and discutient ointment, useful in scrofulous, 
erysipelatous, and malignant ulcers, eruptions of the skin, etc. 

Pile Ointment. — Take three handfuls each of witch hazel bark, 
white oak bark, and sweet appletree bark ; bruise or grind them, and 
add to them three pints of water ; boil down to one pint, and strain ; 
add to this liquid half a pound of lard, and simmer till the water all 
disappears, stirring continually both before and after removing from 
the fire till it cools. 

This forms a brick-colored anodyne, astringent ointment, admira- 
bly adapted to the cure of pile tumors. 



676 MEDICINES AND THEIR PREPARATIONS. 

Compound Lead Ointment. — Take two and a half pounds of olive 
oil, four ounces each of beeswax and unsalted butter, and half a 
pound of white turpentine ; melt them together, strain, and then heat 
to nearly the boiling point ; then gradually add one pound of red 
lead, stirring constantly till the mixture becomes black or brown ; 
then remove from the fire, and when it is partly cool, add to it a 
mixture of twelve ounces of honey, and half a pound of powdered 
camphor. 

This is a very healing ointment, and is much used for ulcers, burns, 
wounds, and skin diseases. 

Compound Sulphur Ointment. — Take one ounce of sulphur, one 
dram each of ammoniated mercury and benzoic acid, one fluid dram 
each of sulphuric acid and oil of bergamot, two drams of nitrate of 
potassa, and half a pound of lard. First, melt the lard with a gentle 
heat, then add the other ingredients, stirring constantly till they are 
cold. 

A sovereign remedy for itch. 

Pills. 

Pills are small masses of medicinal substances, in globular shape, 
and of a size convenient for swallowing. Each pill generally weighs 
from three to five grains. Those medicines which cannot be dissolved 
in water, and are particularly unpleasant to the taste, are usually 
given in the form of pill. Sugar-coated, as now very extensively 
prepared by Tilden & Co., from every important medicine, and in a 
great variety of combination, they will doubtless become a very pop- 
ular form of taking medicine. Physicians cannot do better than to 
use the pills of the abovenamed extensive manufacturing house. 

The method of making pills is as follows : If the substance to be 
worked into pills be a solid extract, add a few drops of water to it, 
and rub it to the right consistence ; if it be a resin, add to it a few 
drops of alcohol ; if it be a soft or liquid substance, rub up with it 
some inert substance, or crumb of bread, or wheat flour, or starch, or 
pulverized gum arable ; if it be a powder, mix it with some soft 
substance, as confection, soap, or syrup, molasses, honey, or mucilage 
of gum arable. The materials must be well mixed and rubbed into 
a uniform mass, which should be rolled with a spatula or case knife, 
into a cylinder of just the same size throughout. This is to be di- 
vided equally into the number of pills required, each of which is 
rolled into a spherical form between the thumb and finger, or upon 
the palm of one hand by the index finger of the other. 

So many valuable pills are prescribed among the " Recipes," that it 
is not necessary hefe to add to their number. 

Plasters. 

Plasters are composed of wax, resins, gums, fats, and oils, and 
sometimes medicinal substances, and are spread upon linen, muslin, 



MEDICINES AND THEIR PREPARATIONS. 677 

or leather, — mostly the latter. When cold they are hard ; but when 
brought to the warmth of the human body, they so far soften as to 
adhere firmly to the skin, but do not " run " so as to spread outward, 
and soil the under-clothes. They are intended generally to excite and 
irritate the skin ; sometimes as mechanical supporters ; and sometimes 
to affect the system by having their medicinal matters absorbed. 

Belladonna Plaster. — Take three ounces of resin plaster, and an 
ounce and a half of extract of belladonna, add the extract to the 
plaster previously melted by a gentle heat, and mix. 

A useful anodyne application in neuralgia, rheumatic pains, and 
dysmenorrhoea. 

ronipound Capsicum Plaster. — Melt together half a pound of resin, 
and two ounces of beeswax ; to this add one pint of spirit in which 
two ounces of powdered cayenne, enclosed loosely in a linen bag, has 
been digested one hour by a gentle heat ; evaporate the spirit by a 
moderate heat, and add one ounce of powdered camphor, and one 
fluid dram and a half of oil of sassafras ; stir constantly till cold. 

This may be used whenever a stimulating plaster is required. 

Compound Galbanum Plaster. — Take tw^o ounces of galbanum, 
three ounces of burgundy pitch, half an ounce of resin, half an ounce 
of yellow wax, and four ounces of lead plaster ; melt them all to- 
gether, o\^r a gentle fire. 

This is a valuable strengthening plaster, and may be used for weak- 
ness of various parts, as well as for scrofulous enlargement of glands 
and joints. 

Compound Lead Plaster. — Take one pound of lead plaster ; melt 
it by a moderate heat, and then add two fluid ounces each of linseed 
oil and tincture of opium, six fluid ounces of oil of turpentine, and 
two thirds of a pound of oil of origanum ; stir together till cold. 

Used for burns, scalds, chilblains, etc. 

Compound Resin Plaster. — Take three pounds of resin, four ounces 
each of beeswax and hemlock gum ; melt the articles together, then 
remove from the fire, and, when nearly cold, add gradually one fluid 
ounce each of oil of hemlock, oil of sassafras, and olive oil, with half 
an ounce of camphor dissolved in them, and half a fluid ounce of oil 
of turpentine. Pour the whole into cold water, and work in the 
hands till cold, forming it into rolls. 

This is an excellent strengthening plaster, useful for rheumatism, 
enlarged joints, glands, and wherever a weakened part needs gentle 
stimulation and support. 

Spiced Plaster. — Take one ounce each of powdered ginger, cloves, 
cinnamon, and black pepper; one dram of pulverized cayenne ; half 
a fluid ounce of tincture of ginger; and a sufficient quantity of honey. 
Mix the powders, and then add the tincture and honey, to form a stiff 
poultice. 

This is applied with great advantage over the stomach in cases of 
nausea and vomiting. 



678 MEDICINES AND THEIR PREPARATIONS. 

Compound Tar Plaster. — Boil three pounds of tar half an hour, 
then add one pound and a half of burgundy pitch, one pound of white 
gum turpentine (after having melted them together and strained). 
Stir together, then remove from the fire, and add ten ounces each of 
finely powdered mandrake root, bloodroot, poke root, and Indian tur- 
nip ; mix thoroughly together. 

This is an irritant, rubefacient, suppurative plaster, and is consider- 
ably used by the Eclectics, to produce counter-irritation and revulsion 
in neuralgia, rheumatism, and other painful affections, as well as in 
chronic inflammation of internal organs. To be spread thinly on soft 
leather, and renewed daily on the same leather. Four days are re- 
quired to produce suppuration. If it produce great pain or inflam- 
mation, remove it, and apply mutton tallow, or elm poultice. 

Lead Plaster. — Take one pound and a quarter of very finely pow- 
dered semi vitrified oxide of lead, one quart of olive oil, and half a 
pint of water. Boil together over a gentle fire, stirring constantly till 
the oil and litharge unite and form a plaster. If the water nearly all 
evaporates before the process is completed, add a little boiling water. 

A useful plaster for ulcers, burns, excoriated surfaces, etc. 

Red Oxide of Lead Plaster. — Melt together one quart of olive oil, 
and one ounce each of beeswax and resin ; heat to the boiling point, 
and then add gradually three quarters of a pound of powdered red lead. 
Stir constantly, and when the oil has taken up the lead, the mixture 
w^ill be brown or shining black ; then remove from the fire, and when 
nearly cold, add four scruples of powdered camphor, and stir together. 
It should not be removed from the fire until it has acquired a proper 
consistence for spreading, w^hich may be easily ascertained by allow- 
ing a portion of it to cool on a knife. 

This is a valuable plaster for scrofulous and syphilitic ulcers, also 
for burns, scalds, and several skin diseases. 

Poultices. — Cataplasms, 

Bread and Water Poultice. — Put the needed quantity of boiling 
water in a basin ; throw in crumbled white bread, or cracker, and 
cover with a plate. When the bread or cracker has soaked up all it 
wnll, drain off the remaining water. Spread one third of an inch 
thick, and apply. 

Flaxseed Poultices. — Put boiling wat^r in a basin, and stir in flax- 
seed meal to make a thick paste. Spread on linen, and apply. 

Yeast Poultice. — Mix half a pint of yeast with one pound of flax- 
seed meal. Stir carefully while heating. 

Carrot Poultice. — Boil the proper quantity of carrots till they are 
quite soft. Strain off the water, mash them to a pulp, and add a little 
lard or sweet oil to prevent them from getting hard, then spread. A 
good application for malignant and oftensive sores. 



MEDICINES AND THEIR PREPARATIONS. 679 

Out Meal Poultice, — Place hot water in a basin, and stir in oat meal 
slowly, while it boils, till the poultice is of the right thickness ; that 
is, till it will not run on the rag on which it is spread. 

Indian Meal Poultice. — Made the same as oat meal poultice. 

Arrow Root Poultice. — Mix two or more tablespoonfuls of arrow- 
root with a little cold water, in a basin, till it is all united with the 
water. Then add boiling water, and stir, till the whole becomes a 
thick paste. 

Slippery Elni Poultice. — Stir ground slippery elm bark into hot 
water, and let it swell. This is a very soothing poultice for irritable 
sores. 

Onion Poultice. — Made in the same way as the carrot poultice. 
This is quite stimulating, and induces indolent sores to maturate 
more freely. It is excellent for slow boils. 

Charcoal Poultice. — Take either the bread and milk, or the Indian 
meal poultice, and stir into it one quarter its bulk of finely pulverized 
charcoal. Excellent for thoroughly cleansing a foul sore or ulcer. 

Anodyne Poultice. — Take half an ounce of the extract either of 
foxglove, or henbane, or stramonium, or conium, or belladonna, and 
mix with it half a pint of tepid water. Then stir in as much flax- 
seed meal as will make a poultice of the right thickness. Always be 
careful not to apply this poultice where there is much skin oft', lest 
the extract used be so much absorbed as to produce poisonous effects. 
These poultices allay the pain of cancerous and other sores. 

Lobelia Poultice. — Powdered lobelia and ground slippery elm bark, 
each, one ounce. Stir these into hot weak lye, to make a poultice. 
For wounds, fistula, whitlow, boils, erysipelas, and stings of insects. 

Poke Root Poultice. — Roast a sufficient quantity of fresh poke 
root in hot ashes. When it is quite soft, pound it, and make a poul- 
tice. To be applied to tumors to scatter them, or hasten their suppu- 
ration. To be removed every four hours. 

Mustard Poultice. — Stir up a tablespoonful of ground mustard 
with a little water, to the consistence of paste. Spread upon linen 
or brown paper, and cover with thin muslin, that the mustard may 
not stick to the skin when the poultice is removed. 

Powders. 

A SINGLE substance used as a powder is called a simple powder ; 
two or more united, a compound powder. Under the above head, I 
shall describe only compound powders. In preparing compound 
powders, the substances, if of different degrees of hardness, should 
generally be pulverized separately. Many powders require to be ex- 
cluded from the light, which may be done by covering the bottles in 
which they are kept with black varnish. 



680 MEDICINES AND THEIR PREPARATIONS. 

Aromatic Powder, — Take two ounces each of cinnamon and gin- 
ger, and an ounce each of cardamom deprived of the capsules, and 
grated nutmeg. Rub them together into a very fine powder, and 
keep in well-stopped bottles. 

The powder is stimulant and carminative, and in cases of weak- 
ened d^estion, may be given in ten to thirty-grain doses. 

Compound Powder of Aloes and Canella, — Take a pound of aloes, 
and three ounces of canella. Rub them separately to a fine powder, 
and mix them. 

This is the preparation known as hiera pier a, or simply pier a. It 
may be used for amenorrhcea, or generally as a bitter to correct cos- 
tiveness, and improve the appetite. 

Compound Powder of Catechu. — Take two ounces each of catechu 
and kino, and half an ounce each of cinnamon and nutmeg. Reduce 
all to a fine powder, mix, and pass them through a fine sieve. 

For chronic diarrhoea, dysentery, etc. Dose, from fifteen to thirty 
grains. 

Compound Powder of Chalk, — Take half a pound of prepared 
chalk, four ounces of cinnamon, three ounces each of tormentil and 
gum arable, and half an ounce of long pepper. Rub them separately 
into a very fine powder, and mix. 

This powder is warm, stimulant, astringent, and antacid, and is 
well fitted for diarrhoea, not connected with inflammation. 

Compomid Powder of Chalk with Opium. — Take six ounces and a 
half of compound powder of chalk, and four scruples of powdered 
opium. Mix them. 

The opium in this preparation increases the efficacy of the com- 
pound powder of chalk in diarrhoea. Dose for an adult, ten to twenty 
grains, and repeated after each discharge. 

Compound Powder of Golden Seal. — Take two drams each of 
powdered golden seal, blue cohosh, and helonias, and mix them. 

Useful in dyspepsia, and chronic inflammation of the mucous mem- 
brane of the stomach, etc. Dose, half a teaspoonful to a teaspoonful, 
three or four times a day. 

Compound Powder of Hydrastin. — Take half a dram each, in 
powder, of hydrastin, leptandrin, rhubarb, and myricin. Mix tho- 
roughly, and divide into thirty-two powders. 

This is tonic and laxative, and is useful in dyspepsia, jaundice, 
chronic inflammation of the bowels, and during recovery from ex- 
hausting complaints. One powder may be taken often enough to 
produce one movement of the bowels a day. 

Inhaling Powder. — Take one dram of crystals of nitrate of silver, 
and two and a half drams of lycopodium. Work the lycopodium 
into a very stiff' paste, with a little warm water, in which the nitrate 
is dissolved. Spread this thin in a shallow dish, cover it so as to shut 
out the light, and set it where it will dry ; when thoroughly dry, pul- 
verize. 



MEDICrNT:S AND THEIR PREPARATIONS. 681 

I have used this powder with great advantage in many oases of 
bronchitis, by directing three or four grains of it to be inhaled once a 
day, in an instrument I had constructed for that purpose. This is the 
only really valuable catarrh snuff ever used. A pinch of it taken once 
a day (never oftener) for nasal catarrh, will often do excellent service. 

Compound Powder of Ipecacuanha. — Take a dram each of pow- 
dered ipecacuanha and opium, and one ounce of sulphate of potassa. 
Rub them together into a fine powder. 

This is the well known Dover's powder. It is an admirable ano- 
dyne and diaphoretic, and is much used in inflammatory complaints, 
particularly rheumatism and pneumonia, complicated with low, ty^ 
phoid symptoms. Dose, from five to fifteen grains. 

Compound Powder of Jalap. — Take half an ounce of pulverized 
jalap and senna, one ounce of pulverized bitartrate of potassa, half a 
dram of pulverized ginger, and ten grains of pulverized cayenne. 
Mix thoroughly. 

This is a valuable purgative medicine, and may be used in most 
cases where a simple cathartic is required. Dose, half a teaspoonful 
to a tablespoonful. 

Compound Powder of Kino. — Take fifteen drams of kino, half an 
ounce of cinnamon, and a dram of dried opium. Rub them sepa- 
rately to a very fine powder, and mix them. 

This is anodyne and astringent, and is useful in diarrhoea, etc. 

Compound Powder of Rhubarb. — Take four ounces of powdered 
rhubarb, one pound of magnesia, and two ounces of finely powdered 
ginger. Mix thoroughly, and preserve in well-stopped bottles. 

An excellent laxative and antacid, and well adapted to the bowel 
complaints of children. 

Comjjound Powder of Rhubarb and Potassa {Neutralizing Powder). 
— Take half an ounce each of powdered rhubarb, bicarbonate of 
potassa, and peppermint leaves. Mix thoroughly. 

Valuable in diarrhoea, cholera morbus, dysentery, summer com- 
plaint of children, sour stomach, heartburn, etc. 

Worm Powder. — Take one ounce each of powdered white Indian 
hemp root (asclepias incarnata), mandrake, pink root, and bitter root ; 
two ounces of powdered balmony, and four scruples of powdered 
aloes. Mix thoroughly. 

A very good remedy for all kinds of worms. A teaspoonful of the 
powder may be mixed with a gill of molasses, and a teaspoonful of 
this given to a child every hour or two till it operates. After this, 
give a teaspoonful three times a day, for a few days. 

Syrups. 

A STRONG solution of sugar and water is 3. simple syrup. When 
the water is first charged with some medicinal substance, and sugar 

86 



682 MEDICINES AND THEIR PREPARATIONS. 

is added to this, we have a medicated syrup. Refined sugar should 
always be preferred, in preparing medicated syrups. 

Simple Syrup. — Take two and a half pounds of refined sugar, and 
a pint of water ; dissolve the sugar in the water by heat, remove any 
scum that may arise, and strain while hot. 

Syrup of Almonds. — Take a pound of sweet almonds, four ounces 
of bitter almonds, three pints of water, and six pounds of refined 
sugar. Blanch the almonds, then rub them in a mortar to very fine 
paste, and add, during the trituration, three fluid ounces of the water, 
and one pound of the sugar. Mix the paste thoroughly with the 
remainder of the water. Strain with strong expression, add the re- 
mainder of the sugar to the strained liquor, and dissolve by a gentle 
heat. Strain through fine linen, and after it is cool, put it into bottles, 
thoroughly stopped, and keep in a cool place- 

This is demulcent, nutritive, and sedative, and is sometimes added 
to cough mixtures, etc. 

Syrup of Citric Acid, — Take two drams of powdered citric acid, 
four minims of oil of lemons, and two pints of syrup. With one fluid 
ounce of the syrup, rub the citric acid and oil of lemons, th^n add 
the remainder of the syrup, and dissolve by a gentle heat. 

This is much employed as an agreeable and cooling addition to 
drinks, especially to carbonic acid water. Tartaric acid, being cheaper 
than citric acid, is often substituted for it, and the preparation thus 
made is much sold under the name of lemon syrup. 

Syrup of Garlic. — Take six ounces of fresh garlic, sliced and 
bruised, one pint of diluted acetic acid, and two pounds of refined 
sugar. Macerate the garlic in ten fluid ounces of the diluted acetic 
acid, in a glass vessel, four days, and express the liquor. Then mix 
the rest with what remains of the acid, and again express, till suffi- 
eient has passed to make the whole when filtered measure a pint. 
Then pour the filtered liquor on the sugar in a bottle, and shake till 
it is dissolved. 

Excellent in the bronchial affections of children. Dose, a teaspoon- 
ful, for a child a year old. 

Syrup of Ginger. — Add two fluid ounces of tincture of ginger to 
a quart of simple syrup ; evaporate the alcohol by a gentle heat. 

This is carminative and stimulant, and gives tone to the debilitated 
stomach, removing wind, etc. It is added to other medicines to im- 
prove their flavor. 

Compound Syrup of Hyi)ophospliites. — - Take 256 grains of hypo- 
phosphite of lime, 192 grains of hypophosphite of soda, 128 grains 
of hypophosphite of potassa, 96 grains of recently precipitated hypo- 
phosphite of iron, 240 grains of hypophosphorous acid solution, 12 
ounces of white sugar, half an ounce of extract of vanilla, and a 
sufficient quantity of water. Dissolve the salts of lime, soda, and 
potassa, in six ounces of water ; put the iron salt into a mortar, and 
gradually add solution of hypophosphorous acid till it is dissolved; 



MEDICINES AND THEIR PREPARATIONS. 683 

to this add the solution of the other salts, after it has been rendered 
slightly acidulous with the same acid, and then water, till the whole 
measures nine fluid ounces. Dissolve this in sugar, with heat, and 
flavor with the vanilla. Without flavoring, this syrup is not unpleas- 
ant, being slightly saline, and not at all ferruginous. Any other 
flavoring may be used, as orange peel, orange flower, or ginger. It 
is also suggested to physicians that glycerine may be used, wholly or 
partially, in place of sugar, when indicated, six ounces and a half of 
glycerine being substituted for twelve ounces of sugar. 

This syrup has been nmch used of late as a new remedy for con- 
sumption, on the authority of Dr. Churchill. It is elegantly manu- 
factured by Dr. James R. Nichols & Co., of this city. Dose, a tea- 
spoonful, three tunes a day before meals. 

Syrnp of Ipecacuanlia. — Take one ounce of ipecacuanha, in coarse 
powder, one pint of diluted alcohol, two pounds and a half of sugar, 
and one pint of water. Macerate the ipecacuanha in the alcohol 
fourteen days, and filter; evaporate the filtered liquor to six fluid 
ounces, filter again, and add water to make the liquor measure a pint; 
then add the sugar, and proceed as directed for syrup. 

This is chiefly used in complaints of children. Dose, as an emetic, 
for an adult, two fluid ounces ; for a child a year or two old, one or 
two fluid drams. As an expectorant, for an adult, two fluid drams ; 
for a child, five to twenty minims. 

Syrup of Lemons. — Take a pint of strained lemon juice, two 
pounds and a half of refined sugar, and two and a half fluid ounces 
of rectified spirit; boil the juice ten minutes, and strain; then add 
the sugar, and dissolve. After the syrup has cooled, mix the spirit 
with it. 

A cooling and grateful addition to drinks in fevers, and serves to 
cover the taste of salts and other purgatives. 

Aromatic Syrup of Rhubarb. — Take two ounces and a half of 
bruised rhubarb, half an ounce each of bruised cloves and cinnamon, 
two drams of bruised nutmeg, two pints of diluted alcohol, and six 
pints of syrup. Macerate the rhubarb and aromatics in the alcohol 
for fourteen days, and strain ; then, by a gentle heat, evaporate the 
liquor to a pint, and, while hot, mix it with the syrup previously 
heated. 

This is a warm cordial laxative, admirably fitted for the bowel 
complaints of infants. Dose, a fluid dram, repeated every two hours 
till it operates. 

S^Tup of Seneka. — Take four ounces of fluid extract of seneka, and 
one pint of water ; mix, and dissolve in the liquid one pound of refined 
sugar, and proceed as directed for syrup. 

This is a stimulating expectorant, used in colds, coughs, etc., after 
inflammatory symptoms have subsided. Dose, for an adult, one or 
two teaspoonfuls, as often as necessary. 

Syrup of Squill. — To one pint of vinegar of squill, add two pounds 
of refined sugar, and proceed as directed for syrup. 



6>^4 MEDICINES AND THEIR PREPARATIONS. 

It is a useful expectorant for coughs and bronchial affections of 
infants and children. Dose, half a dram to a dram. 

Syrup of Tolu. — Take two fluid ounces of tincture of tolu, and 
one pint of simple syrup ; mix, and gently heat the mixture to evapo- 
rate the alcohol. 

This is chiefly used to flavor other preparations. 

Syrup of Wild-Cherry Bnrk. — Place two pounds and a half of 
coarsely powdered wild-cherry bark in a percolator, and pass through 
it one gallon of water. Strain this, and dissolve in it by heat sixteen 
pounds of refined sugar. 

This makes an elegant tonic and sedative preparation, and is mixed 
with various other articles in prescribing for dyspepsia, consumption, 
etc. 

Compouud Syrup of Partridoe Berry. — Take half a pound of par- 
tridge-berry, and two ounces each of helonias, blue cohosh, and high 
cranberry bark ; add to them one quart of brandy, and macerate four 
days. Press out the brandy; and place the herbs in three quarts of 
boiling water, and boil down to two and a half pints. Strain, add one 
pound of sugar, and evaporate to two and a half pints. Remove from 
the fire, and when nearly cold, add the brandy previously pressed out. 

This is considerably used by the Eclectic physicians, under the 
name of motker^s cordial; and may be usefully employed by all phy- 
sicians in suppression of the menses, painful menstruation, profuse 
menstruation, and habitual abortions. Dose from one to two ounces, 
two or three times a day. 

Compound Syrup of Phosphates ( Chemical Food). — Take ten drams 
of protosulphate of iron, twelve drams of phosphate of soda, twelve 
drams of phosphate of lime, twenty drams of phosphoric acid (glacial), 
two scruples of carbonate of soda, one dram of carbonate of potassa, 
sufficient quantity of muriatic acid, sufficient quantity of water of 
ammonia, two drams of powdered cochineal, sufficient water to make 
twenty fluid ounces, three pounds of sugar, and fifteen drops of oil 
of orange. Dissolve the sulphate of iron in two fluid ounces of boil- 
ing water, and the phosphate of soda in four fluid ounces of boiling 
water. Mix the solutions, and wash the precipitated phosphate of 
iron till the washings are tasteless. 

Dissolve the phosphate of lime in four fluid ounces of boiling water, 
with sufficient muriatic acid to make a clear solution, precipitate it 
with water of ammonia, and wash the precipitate. 

To the freshly precipitated phosphates, as thus prepared, add the 
phosphoric acid, previously dissolved in the water. When clear, add 
the qarbonates of soda and potassa, and afterwards sufl^icient muriatic 
acid to dissolve the precipitate. 

Now add the cochineal mixed with the sugar, apply heat, and when 
the syrup is formed, strain and flavor it. 

This is an elegant syrup, agreeable both to the eye and taste, and 
has been extensively sold and used as a nutritive tonic, in chronic de- 
bility, in cases of broken down constitution, wasting of the flesh, etc. 



I^IEDICIXES AND THEIR PREPARATIONS. 685 

Coiiipoiiiid 8yrup of Rhubarb and Potassa (Neutralizing Cordial). — 
Take half a pound each of powdered rhubarb and bicarbonate po- 
tassa, and four ounces each of cinnamon and golden seal ; macerate 
for four days in one gallon of best fourth proof brandy. Express the 
tincture with strong pressure, and add to it two fluid drams of oil of 
peppermint, previously dissolved in a little alcohol. Break up the 
cake from the press, place it in a percolator, and gradually pass 
through it warm water till the strength is exhausted. Evaporate this 
solution to four quarts, and while the liquor is still hot, dissolve in it 
six pounds of refined sugar. Continue the evaporation, if necessary, 
till the addition of the tincture first obtained will make three gallons, 
Then add the tincture. 

A valuable antacid and laxative in diarrhoea, dysentery, cholera 
morbus, and summer complaint of children. Dose, for an adult, a 
tablespoonful, to be taken as circumstances require. 

Coiiipoiiiid SjTiip of Sarsaparilla. — Take a pound each of sarsa- 
parilla, yellow parilla, and pipsissewa; an ounce and a half of guaia- 
cum ; one ounce each of red roses, senna, and liquorice root ; and 
three minims each of oil of sassafras, anise, and partridge-berry; di- 
luted alcohol, five pints, and four pounds of refined sugar. Grind 
and mix the sarsaparilla, yellow parilla, pipsissewa, guaiacum, roses, 
senna, and liquorice, and add to them the alcohol. Let the whole 
stand fourteen days ; then express and filter. Evaporate by a water 
bath to one quart, and add the sugar. Lastly, rub the oils in a mor- 
tar w4th a little of the syrup, and thoroughly mix with the remainder. 

This is a valuable alterative syrup, and is used for syphilis, scrofula, 
diseases of the skin, etc. It is much improved by adding half an 
ounce of the iodide of potassium to each pint of the syrup. Dose, a 
tablespoonful. 

Compound Aromatic Syrup of Senna. — Take four ounces of senna, 
one ounce and a half of jalap root, half an ounce of rhubarb, one 
dram of cinnamon, one dram of cloves, and half a dram of nutmeg. 
Reduce these articles to a coarse powder ; add one quart of diluted 
alcohol. Let the whole stand two days, and percolate. Filter, dis- 
solve in it one pound of refined sugar, and add one dram of oil of 
lemons. 

An excellent cordial physic. 

Compound Syrup of Stillingia. — Take a pound each of queen's 
root and turkey corn ; half a pound each of pipsissewa leaves and 
elder flowers ; and four ounces each of prickly ash berries and carda- 
mom seeds. Grind all the articles, mix, and place them in a jar, and 
moisten them well with alcohol. Let them stand two days; then 
place them in a percolator, and gradually add hot water till two pints 
are obtained, which must be strained and set aside. Then continue 
the percolation so long as there is a sensible taste of the spirit. Re- 
serve this also. Then continue the percolation till what is obtained 
is almost tasteless. Boil down this last till the addition of the two 
reserved tinctures will make two gallons of the whole. Now add 
twelve pounds of refined sugar, and make a syrup. 



686 MEDICINES AND THEIR PREPARATIONS. 

This is one of the Eclectic medicines ; and is quite an effective 
alterative for syphilis, scrofula, etc. Improved by adding iodide of 
potassium. Dose, from a teaspoonful to a tablespoonful. 

Compound Syrup of Yellow Dock. — Take two pounds of yellow 
dock root, one pound of the bark of the root of false bittersweet, and 
half a pound each of American ivy and figwort. Make a syrup ac- 
cording to the directions for compound syrup of stillingia, using six- 
teen pounds of sugar, and making two gallons of syrup. 

A valuable preparation for scrofula. Improved by iodide of potas- 
sium. Dose, a tablespoonful, three or four times a day. 

Tinctures. 

For a description of the method of making tinctures, see page 588, 
I will simply add here, that an ethereal tincture is one which is made 
with ether as the solvent instead of alcohol, and an ammoniated tinc- 
ture, one made with water of ammonia as the solvent. 

Simple tinctures, in which only one medicinal article is used, are 
made thus : 

Tincture of Aconite. — Take eight ounces of powdered acoriite root, 

and one pint of alcohol. Mix, and let them stand for two weeks, fre- 
quently stirring. Then express, and filter through paper. 

Given in fevers and inflammatory diseases. Dose, three drops 
every hour or two in a little water. 

In the above manner all simple tinctures are made. Some medi- 
cines require alcohol to extract their active principle ; some only 
diluted alcohol. 

One Ounce to the Pint of Alcohol. — In preparing simple tinctures 
from the following articles, alcohol is used, and one ounce only of the 
medicine is employed to the pint, namely : 

Castor, Saffron, Leptandria. 

One Ounce to the Pint of Diluted Alcohol. — In making tinctures 
from the following articles, one ounce is used to the pint of diluted 
alcohol : 

Iodine, Quassia. 

Two Ounces to a Pint of Alcohol : 

Assafcetida, Camphor, Oil of Peppermint, Oil of Spearmint, Ben- 
zoin, Colchicum seeds, Lupulin. 

Two Ounces to a Pint of Diluted Alcohol : 

Cardamom, Cotton Bark, Cochineal, Colombo, Colchicum, Ergot, 
Galls, Hemlock, Cubebs, Foxglove, Black Hellebore, Henbane, Lactu- 
carium. Lobelia, Poke, Shrubby Trefoil, Bloodroot, Squill, Valerian, 
Bittersweet, Belladonna. 

Tliree Ounces to a Pint of Diluted Alcohol : 

Peruvian Bark, Rhatany, Poison Hemlock, Sheep Laurel, Stramo- 
nium, White Hellebore, Yarrow, Prickly Elder, Jalap. 



MEDICINES AND THEIR PREPARATIONS. 687 

Four Ounces to a Pint of Alcohol : 

Nux Vomica, Ginger, Guaiacum, Black Cohosh 

Four Ounces to a Pint of Diluted Alcohol : 

Yellow Jessamine, Prickly-ash Berries, Ergot, Matico. 

The following tinctures embrace those which vary from the above 
proportions among the simple tinctures, and also the compound tinc- 
tures : 

Tincture of Oran«;e Peel. — Take three and a half ounces of dried 
orange peel, and one quart of diluted alcohol. Macerate for seven 
days, express and filter. 

Tincture of Buchu. — Take five ounces of buchu, and one quart of 
diluted alcohol. Digest seven days ; pour off the clear liquor, and 
filter. 

Tincture of Indian Hemp. — Take of extract of Indian Hemp 
(Cannabis Indica) one ounce, and one pint of alcohol. Dissolve the 
extract in the spirit. Dose, from twenty to forty drops. 

Tincture of Cantliarides. — Take an ounce of bruised Spanish flies, 
and two pints of diluted alcohol. Macerate for fourteen days, express 
and filter through paper. 

Dose, from twenty drops to a dram, three or four times a day. 

Tincture of Cayenne Pepper. — Take an ounce of pulverized cay- 
enne, and two pints of diluted alcohol. Macerate fourteen days, and 
filter through paper. 

Tincture of Catechu. — Take an ounce and a half of catechu, an 
ounce of bruised cinnamon, and one pint of diluted alcohol. Let 
them stand together two weeks, frequently shaking ; then express and 
filter. 

Dose, from thirty drops to a tablespoonful. 

Tincture of Cinnamon. — Take an ounce and a half of powdered 
cinnamon, and one pint of diluted alcohol. Let them stand together 
for two weeks ; express and filter. 

Dose, from one to four teaspoonfuls in sweetened water. 

Elixir Yitriol. — Take half a pint of alcohol; drop into it seven 
fluid drams of sulphuric acid, and let the mixture stand three days in 
a close vessel ; then add two drams of powdered ginger, and three 
drams of powdered cinnamon. Macerate seven days, and filter. 

Useful in diarrhoea, dysentery, etc. Dose, from five to twenty drops. 
To avoid injury to the teeth, it should be taken through a quill, or else 
the mouth should be rinsed immediately after swallowing it. 

j Tincture of Lobelia. — Take four ounces of lobelia, and one pint 

j each of distilled vinegar and alcohol. Macerate two weeks, express 

I and filter. 

j Dose, as a nauseant or expectorant, from thirty to sixty drops. 

Tincture of Opium {Laudanum). — Take two and a half ounces of 



688 MEDICINES AND THEIR PREPARATIONS. 

opium, and two pints of diluted alcohol. Macerate fourteen days, 
express, and filter through paper. Dose, from ten to twenty-five 
drops. 

Tincture of Tolu. — Dissolve one ounce of tincture of tolu in one 
pint of alcohol, and filter. 

Tincture of Rhubarb. — Take three ounces of bruised rhubarb, half 
an ounce of bruised cardamom, and a quart of diluted alcohol. Mac- 
erate two weeks, express, and filter through paper. 

Tincture of Virginia Snake Root. — Take three ounces of bruised 
Virginia snake roof, and one quart of diluted alcohol. Macerate two 
weeks, express, and filter through paper. 

This is advantageously added to the infusion of Peruvian bark, in 
low states of the system. Dose, one to two fluid drams. 

Compound Tincture of Aloes. — Take three ounces of powdered 
aloes, one ounce of saffron, and two pints of tincture of myrrh. Mac- 
erate fourteen days, and filter. 

This is the well known elixir propria tatis, or, more commonly, elixir 
pro. It is considerably used in female disorders, connected with sup- 
pressed, retained, or deficient menstruation. Dose, one to two fluid 
drams. 

Compound Tincture of Assafoetida. — Take half an ounce each of 
lupulin, assafoetida, in small pieces, bruised stramonium seeds, pow- 
dered valerian root, and one pint and a half of alcohol ; macerate two 
weeks, shaking frequently, then express and filter. 

This is anodyne and antispasmodic, and is used in epilepsy, St. 
Vitus's dance, and hysterics. Dose, a teaspoonful. 

Compound Tincture of Benzoin. — Take three ounces of benzoin, 
two ounces of purified storax, one ounce of balsam of tolu, half an 
ounce of powdered aloes, and two pints of alcohol. Macerate two 
weeks, and filter. 

This is used in chronic diseases of the air passages. Dose, from 
thirty to sixty drops. 

Compound Tincture of Cardamom. — Take six drams of bruised 
cardamom, two ounces of bruised caraway, five drams of bruised 
cinnamon, five ounces of seeded raisins, one dram of bruised cochi- 
neal, and two pints and a half of diluted alcohol. Macerate two 
weeks, and filter. 

This is a very agreeable aromatic; used as a carminative, and to 
improve other preparations. Dose, one or two fluid drams. 

Compomid Tincture of Catechu. — Take three ounces of catechu, 
two ounces of bruised cinnamon, and two pints of diluted alcohol. 
Macerate fourteen days, express and filter. 

This is frequently added to chalk preparations for diarrhoea, etc. 
Dose, from one to three fluid drams. 

Compound Tincture of Ciimamon. — Take one ounce of bruised cin- 
namon, half an ounce of bruised cardamom seeds, three drams of 



MEDICINES AND THEIR PREPARATIONS. 689 

bruised ginger, and two pints of proof spirits. Macerate fourteen 
days, express, and filter. 

This is a warm, aromatic tincture, useful in spasms, and debility of 
the stomach. Dose, one to two fluid drams. 

Compoimd Tincture of Black Cohosh. — Take one fluid ounce of 
tincture of black cohosh, half a fluid ounce of tincture of bloodroot, 
and two fluid drams of tincture of poke root. Mix. 

This is used in diseases of the lungs, liver, and stomach. Dose, 
from twenty to sixty drops, three or four times a day. 

Compound Tincture of Bhie Cohosh. — Take one ounce of powdered 
blue cohosh root, half an ounce each of bruised water pepper and 
ergot, two fluid drams of oil of savin, and twelve fluid ounces of 
alcohol ; mix, macerate for a fortnight, and filter. 

A uterine tonic, used for suppressed and painful menstruation, etc. 
Dose, a teaspoonful, two or three times a day. 

Compound Tincture of Colchicum. — Mix one fluid ounce each of 
tincture of black cohosh and tincture of colchicum seed. 

Used for inflammatory rheumatism and gout. Dose, ten to sixty 
drops. 

Compound Tincture of Gentian. — Take two ounces of bruised 
gentian, one ounce of orange peel, half an ounce of bruised carda- 
mom seeds, and two pints of diluted alcohol. Macerate fourteen 
days, express, and filter. 

An elegant bitter, much used in dyspepsia, and as an addition to 
tonic mixtures for a weakened state of the stomach. Dose, one or 
two fluid drams. 

Compound Tincture of Gohlen Seal. — Take one ounce each of 
powdered lobelia seed and golden seal, and one pint of diluted alco- 
hol. Macerate two weeks, express, and filter. 

This is used as a local application to diseased mucous membranes, 
in leucorrhoea, gleet, etc. 

Ammoniated Tincture of Guaiac. — Take four ounces of powdered 
guaiac, and a pint and a half of aromatic spirits of ammonia. Mac- 
erate for two weeks, and filter. 

This tincture has considerable reputation in the treatment of chronic 
rheumatism. Dose, one or two fluid drams. 

Compound Tincture of Hemlock {Golden Tincture). — Take one 
ounce each of powdered balsam of tolu, guaiacum, gum hemlock, 
and gum myrrh, one ounce and a half of oil of hemlock, one ounce 
of oil of winter green, and four pints of alcohol. Mix, let them 
stand fourteen days, shaking frequently, then filter. 

This is used by the Eclectics for rheumatism, wind colic, water 
brash, soreness of the chest, etc. Dose, a teaspoonful in a wineglass- 
ful of water. 

Compound Tincture of High Cranberry. — Take one ounce of high 
cranberry bark, powdered, half an ounce each of powdered lobelia 
seed and bruised skunk cabbage seed, two drams each of bruised 

87 



690 MEDICINES AND THEIR PREPARATIONS. 

stramonium seed, powdered bloodroot, and capsicum, and two pints 
of alcohol. Macerate two weeks, express, and filter. 

This is an Eclectic remedy, and is useful in nervous and spasmodic 
complaints, particularly hysterics, etc. Dose, from twenty drops to a 
teaspoonful. 

Compound Tincture of Lavender. — Take three fluid drams of oil 
of lavender, one dram and a half of oil of anise, one ounce of pow- 
dered cloves, three drams of mace, two ounces of red saunders, four 
fluid drams of brandy, and one gallon of Jamaica rum. Mix, and 
macerate fourteen days ; then express and filter. 

This is often used for flatulence, hysterics, and faintness. Dose, 
from one to three teaspoonfuls, in water. 

Compound Tincture of Lobelia (Dr. J. King's Expectorant Tincture). 
— Take one ounce each of coarsely powdered lobelia, bloodroot, skunk 
cabbage, wild ginger, and pleurisy root. Place them in a vessel, and 
pour over them one pint of boiling water or vinegar, and cover tightly. 
When cold, add three pints of alcohol. Macerate two weeks, then 
express and filter. 

A valuable emetic for infants and children, in croup, hooping-cough, 
bronchitis, and convulsions. Used also as an expectorant, in coughs, 
pleurisy, etc. Dose, as an emetic for a child, half a teaspoonful and 
upwards. 

Compound Tincture of Lobelia and Capsicum. — Take one ounce 
each of powdered lobelia, capsicum, and skunk cabbage, and one pint 
of diluted alcohol. Mix, macerate fourteen days, and filter. 

A prompt antispasmodic in cramps, spasms, lock-jaw, etc.. Dose, 
half a dram to a dram. 

Compound Tincture of Myrrh (Hot Drops). — Take four ounces of 
bruised myrrh, two ounces of capsicum, and four pints of alcohol. 
Mix, macerate a fortnight, and filter. 

Applied externally, and occasionally given internally for distress of 
stomach, flatulence, etc. 

Camphorated Tinctuie of Opium. — Take one dram each of pow- 
dered opium and benzoic acid, one fluid dram of oil of anise, two 
ounces of clarified honey, two scruples of camphor, and two pints of 
diluted alcohol. Macerate fourteen days, and filter. 

This is known to all the world as paregoric elixir. It is an agree- 
able anodyne and antispasmodic, and a good deal used among chil- 
dren to allay cough, and to relieve pains, diarrhoea, etc. 

Compound Tincture of Peruvian Bark. — Take two ounces of red 
bark, powdered, one ounce and a half of bruised orange peel, three 
drams of bruised Virginia snake-root, one dram each of saffron, cut, 
and red saunders, rasped, and twenty fluid ounces of diluted alcohol. 
Macerate two weeks, express, and filter. 

This is Huxham's tincture. It is an excellent stomach cordial, and 
is used with advantage in low forms of fever, etc. Dose, from one to 
four fluid drams. 



IVrEDlCINES AND THEIR PREPARATIONS. 691 

Coiiipoimd Tincture of Rhubarb (Siceet Tincture of Rhubarb). — 
i Take two ounces and a half of bruised rhubarb, six drams of bruised 
I liquorice root, three drams each of bruised ginger and saffron, two 
j ounces of refined sugar, and one quart of diluted alcohol. Macerate 
j one week, express, and filter, 
i A warm, gentle aperient, well fitted for debilitated states of the 

i stomach. Dose, from a dram or two to an ounce. 

I 

I Tincture of Senna and Jalap (Elixir Salutis). — Take three ounces 

I of senna, one ounce of powdered jalap, half an ounce each of bruised 

coriander and caraway seeds, two drams of bruised cardamom seeds, 

four ounces of sugar, and three pints of diluted alcohol. Macerate 

two weeks, express, and filter. 

This is a warm cordial purgative, useful in costiveness, and gout 

attended with debility. Dose, two fluid drams to an ounce. 

Compound Tincture of Tamarac (Boners Bitters). — Take three 
ounces each of tamarac bark and juniper berries, two ounces of 
prickly-ash bark, one ounce and a half each of wild-cherry bark and 
seneca snake-root, and half an ounce of tansy ; powder coarsely, and 
mix ; then add one pint and a half of whiskey, and let them stand 
twenty-four hours ; then place the whole in a vapor displacement 
apparatus, and force through the mixture, the vapor of another pint 
of whiskey, after which, steam from water enough to make the tinc- 
ture equal to six quarts. To this add twelve ounces of molasses, and 
six drams of thoroughly dissolved alcoholic extract of mandrake. 

This is tonic, diuretic, and aperient. Useful in dyspepsia, etc. 
Dose, a tablespoonful three times a day. 

Animoniated Tincture of Valerian. — Take four ounces of bruised 
valerian, and one quart of aromatic spirit of ammonia. Macerate 
two weeks, express, and filter. 

This is used as an antispasmodic in hysterics, and other nervous 
diseases. Dose, one or two fluid drams, in sweetened water. 

Compound Tincture of Virginia Snake-root {Sudorific Tincture). — 
Take eight scruples each, in coarse powder, of Virginia snake-root, 
ipecacuanha, saffron, opium, and camphor, and one pint of Holland 
gin, or proof spirit. Mix, macerate two weeks, express, and filter. 

This tincture tends powerfully to induce perspiration, and is used 
for such purpose when it is desirable to procure sleep, etc. Dose, from 
ten drops to a teaspoonful, every hour or two, in catnip or balm tea. 

Vinegars. 

Vinegar of Lobelia. — Take two ounces of powdered lobelia seed, 
and one pint of distilled vinegar. Macerate in a close vessel one 
week ; then express and filter, and add one fluid ounce of alcohol. 

This is useful as an emetic and expectorant ; externally, it is val- 
uable in skin diseases. Dose, one to four teaspoonfuls, as often as 
necessary. 



692 MEDICIl^S AND THEIR PREPARATIONS. 

Vinegar of Squill. — Take two ounces of sliced squill, and one pint 
of distilled vinegar ; macerate in a close glass vessel one week ; then 
express, strain, and add one fluid ounce of alcohol. 

This is expectorant and diuretic, and is sometimes used for coughs, 
and diseases of the chest. 

Miscellaneous. 

The recipes of a few popular proprietary medicines are given here 
merely as matters of curiosity. 

Brandreth's Pills. — Take two pounds of aloes, one pound of gam- 
boge, four ounces of extract of colocynth, half a pound of castile soap, 
two fluid drams of oil of peppermint, and one fluid dram of cinna- 
mon. Mix, and form into pills. 

BroAVii's Bronchial Troches. — Take one pound of pulverized ex- 
tract of liquorice, one and a half pounds of pulverized sugar, four 
ounces of pulverized cubebs, four ounces of pulverized gum arabic, 
and one ounce of pulverized extract of conium. Mix. 

Hunter's Red Drop. — Take ten grains of corrosive sublimate, 
twelve drops of muriatic acid, and one fluid ounce of compound 
spirits of lavender. Dose, five to twenty drops in water, or white 
wine, sufficient to produce one evacuation daily, but not over two. 

Ayer's Cherry Pectoral. — Take four grains of acetate of morphia, 
two fluid drams of tincture of bloodroot, three fluid drams each of 
antimonial wine and wine of ipecacuanha, and three fluid ounces of 
syrup of wild cherry. Mix. 

Mackenzie's Ointment. — Take four ounces of powdered sulphate 
of zinc, one ounce of liquid storax, and one pint of lard ; mix, and 
boil slowly one hour, stirring all the time. 

For tetter, scald head, and other diseases of the skin. To be ap- 
plied twice a day, washing the part with castile soap-suds daily. 

Wood's Hair Restorative. — Take four drams of lac sulphur, two 
drams of sugar of lead, and one pint of rose water. Mix. 

Frey's Vennifu^e. — Take one ounce of castor oil, one ounce of 
aromatic syrup of rhubarb, thirty drops of oil of chenopodium, five 
drops of croton oil. Mix. 

Conchlin's Salve. — Take twelve ounces of resin, and one ounce each 
of beeswax, mutton, and tallow ; melt together, strain, and work into 
rolls in cold water. 



PRESCRIPT IONS. -RECIPES. 



These prescriptions are numbered, and referred to by corresponding 
numbers in the treatment of the various diseases. This arrangement 
saves the trouble of writing out each prescription every time it is 
wanted under the several disorders. When there are several recipes, 
each of which is suitable in a certain stage of a complaint, this plan 
affords the means of referring to them all in a little space, by simply 
giving their numbers. The doses named are always for grown per- 
sons^ unless it is otherwise stated. 

Great pains have been taken in preparing these prescriptions. A 
considerable portion of them are the favorite recipes of the most dis- 
tinguished physicians, the world over. 

The classification of these recipes under separate heads, is necessa- 
rily very imperfect, and has been attempted only to make it more 
easy for me to refer to them while writing the book. The classifica- 
tion could only be applied to a part of them, however ; the rest are 
indiscriminately mixed. 

Pukes. Emetics. 

1. Pulverized Ipecac, 1 scruple ; pulverized cayenne, 10 grains ; water, 2 
ounces. Mix. To be taken at a draught. 

2. Pulverized Lobelia, 1 oz. ; pulv. blood root, \ oz. ; pulv. skunk cabbage, 
^ oz. ; pulv. ipecac, 6 drams ; pulv. cayenne, 4 scruples. Mix. An excellent 
emetic in all cases where one is required. Dose, — One-half teaspoonful in 
warm water, and repeat every fifteen minutes three or four times. 

3. Wine of Antimony, 1 dram ; wine of ipecac, 1 oz. Mix. 

4. Tartar Emetic, 1 grain ; pulverized ipecac, 1 scruple. Mix. To be 
taken in a wine-glassful of sweetened water. 



o* 



Purges. Cathartics. 

5. Precipitated Sulphur, 15 grains; magnesia, 1 scruple. Mix. To be 
taken each night at bedtime, for costiveness and bleeding piles. 

6. Confection of Senna, 2 ozs. ; cream of tartar, 1 oz. ; sulphur, 1 oz. ; 
syrup of ginger enough to make a stiff paste. Mix. A piece as large as a 
nutmeg is to be taken as often as necessary to keep the bowels open. One of 
the very best remedies for piles. 



694 PRESCRIPTIONS. — RECIPES. 

7. Rochelle Salts, 2 drams ; bi-carbonate of soda, 2 scruples ; water, ^ 
pint. Mix. To this mixture add 35 grains of tartaric acid, and take the 
whole foaming. This is the recipe for Seidlitz powders. 

8. Calcined Magnesia, 1 dram; water, 2 ozs. Mix. To be taken at a 
draught. 

9. Sulphate of Magnesia, (epsom salts), 2 drams ; freshly roasted coffee 
in coarse powder, 2 scruples ; hot water, 4 ozs. Mix and boil for three minutes, 
and strain. This may be sweetened, and taken every morning for habitual cos- 
tiveness, or repeated once in three hours, if an immediate effect is desired. 

10. Castor Oil, 1 oz. ; the yolk of one egg ; put together, and add, simple 
syrup, ^ oz. ; peppermint water, 2 ozs. Mix. To be taken at a draught, after 
being weU stirred or shaken. 

11. Sulphur, 1 dram; cream of tartar, 2 drams. Mix. To be taken in 
syrup or molasses. 

12. Rhubarb, 10 grains ; calcined magnesia, \ dram. IVIix. To be taken 
in syrup or molasses. 

13. Powdered Senna, \ dram ; powdered jalap, 10 grains ; powdered cloves, 
10 grains ; JVIix. To be taken in sweetened water. 

14. Powdered Jalap, 10 grains; cream of tartar, 2 drams. Mix. To be 
taken in syrup or molasses. 

15. Fluid Extract of Senna and Jalap, 2 drams; infusion of cloves, 2 
ozs. Mix. To be taken at a draught. 

16. Castor Oil, 1 dessert spoonful; oil of turpentine, 1 dessert spoonful. 
Mix. 

1 7. Castor Oil, 1 dessert spoonful ; magnesia, 1 dessert spoonful. Rub 
together into a paste. By this combination, the taste of the oil is almost en- 
tirely concealed, and children will take it without opposition. 

18. Sulphate of Magnesia, 1 oz. ; cream of tartar, 1 oz. ; pure water, 
1 pint. Mix. A wine-glassful occasionally. 

19. Compound Extract of Colocynth, ^ dram; blue pill, 8 grains. Mix, 
and divide into 8 pills. 

20. Epsom Salts, 2 ozs. ; tartar emetic, 1 grain ; spearmint water, 1 pint. 
Mix. 

21. Senna, 3 drams ; salts, ^ dram ; manna, ^ dram ; fennel seed, I dram ; 
boiling water, ^ pint. Macerate for one hour in a covered vessel, and strain. 
Take a teacupful once in four hours, till it operates. 

22. Aloes, 2 scruples ; carbonate of potassa, 15 grains ; decoction of barley, 
^ pint. ]VIix, and rub together. 

23. Sulphur, 1 teaspoonful ; cream of tartar, 10 grains ; saltpetre, 5 grains. 
Mix. To be taken at a dose. 

24. Manna, 2 drams ; fennel water, 1 oz. Mix. One dessert spoonful, 
as a cathartic for an infant. 

25. Compound Infusion of Senna, 4 ozs. ; caraway water, 2 ozs. ; tartrate 
of potassa, 2 drams ; manna, 1 dram. Mix. A tablespoonful for a child, to 
relieve costiveness. 

26. Calcined Magnesia, 1 scruple ; pulverized rhubarb, 1 scruple ; pulver- 
ized ipecac, 1 grain. Mix. Give one-fourth of this daily. 



PRESCRIPTIONS. — RECIPES. 695 

27. Epsom Salts, 2 di-ams ; dissolve in pure water, 1 oz. Then add sweet 
spirits of nitre, 2 drams ; laudanum, 10 drops. Dose. — A teaspoonful, to be 
repeated according to circumstances. 

28. Pulverized Rhuharh, 1 scruple ; leptandrin, 10 grs. ; calcined magnesia, 
2 scruples ; pulverized cinnamon, 10 grains. Mix. Three or four grains every 
third hour, to a child of six months. 

20. Compound Extract of Colocynth^ \ dram ; extract of jalap, 15 grains. 
Mix. Make 12 pills. Two or three pills wdll produce active operation of the 
bowels. 

30. Pulverized Senna, 2 drams ; bicarbonate of potassa, 2 ozs. ; pulver- 
ized cayenne, 10 grains ; pulverized jalap, 1 dram. Mix. Divide into 12 
parts. One part for an adult every four hours till it operates. 

31. Pulverized Gamboge, 12 grs.; pulv. scammony, 12 grs.; elaterium, 2 
grs. ; croton oil, 8 drops ; ext. of stramonium, 3 grs. Mix. Make 12 pills. 
One pill is a dose, repeated every hour until it operates. 

32. Pulverized Scammony, 12 grs. ; pulv. gamboge, 12 grs. ; pulv. colocynth, 
8 grs. ; castile soap, 4 grs. ; oil of anise, 5 drops. Mix. Make 12 pills. One 
pill, repeated every three hours till it operates. 

33. Pulverized Scammony, 6 grs. ; croton oil, 4 drops ; pulv. loaf sugar, 1 6 
teaspoonfuls. Rub well together in a mortar. Give one teaspoonful every 
hour or two, to a child 7 years old, till it operates. 

34. Leptandrin, 1 dram ; podophyllin, 1 scruple ; scutillarine, 2 drams ; 
pulv. cayenne, 1 scruple ; pulv. loaf sugar, 4 ozs. Rub together for some time 
in a mortar. Dose for an adult, -^ of the above. 

35. Pulverized Rhubarb, 2 scruples ; bicarbonate of potassa, 1 scruple ; ext. 
of nux vomica, 5 grs. Mix. Make 20 pills. One pill twice a day. 

36. Leptandrin, 1 dram; podophyllin, 1 scruple; apocynin, 1 scruple; 
ext. nux vomica, 6 grs.; castile soap, 1 dram. Make 30 pills. One pill every 
night. 

37. Sweet Tinct. of Rhubarb, 4 ozs. ; bicarbonate of soda, 2 drams. Mix. 
From a teaspoonful to a tablespoonful, as occasion may require. 

38. Pulverized Rhubarb, 2 ozs. ; bicarbonate of potassa, 1 oz. Mix. Of 
this take enough to produce one movement of the bowels per day. 

39. Leptandrin, 30 grs. ; podophyllin, 10 grs. ; pulv. cayenne, 10 grs. ; ext. 
nux vomica, 6 grs. ; quinine, 12 grs. Mix. Make 24 pills. One, two, or 
three times a day. 

40. Podophyllin, 15 grs. ; leptandrin, 2 scruples ; cream of tartar, 5 scru- 
ples. Mix. Divide into 10 powders. One is a dose. 

41. Comp. Powder of Jalap, 1 oz.; cream of tartar, 1 oz. Mix. One tea- 
spoonful is a dose^ to be taken in sweetened water. 

42. Pulverized Charcoal, \\ drams; pulverized rhubarb, 2 scruples ; pul- 
verized ipecac, 6 grains ; extract of hyoscyamus, 12 grs. Mix. Divide into 
12 portions. Give one every three or four hours. 

43. Pulverized Blood-root, 1 dram ; pulv. rhubarb, 1 dram ; castile soap, 2 
scruples. Mix, and divide into 32 pills. Take one morning and night. Ex- 
cellent for costivfeness. 



696 PRESCRIPTIONS. — RECIPES. 

44. Rochelle, 14 drams ; magnesia, 11 drams; powdered charcoal, 8 drams. 
Mix. Dose. — A heaping teaspoonful in dyspepsia and costiveness, with foul 
breath, etc 

45. Pulverized Hhubarb, 8 grs. ; pulv. guaiacum, 8 grs. ; galbanum, 2 grs. ; 
pulv. ipecac, 2 grs. Mix. Make 8 pills. Take one to two pills night and 
morning. For a weak stomach, and a bilious condition. 

Tonic and Cathartic. 

46. Podophyllin^ 4 grs. ; leptandrin, 8 grs. ; quinine, 8 grs. ; ext. nux vom- 
ica, 2 grs. Mix. Make 1 6 pills. One, two, or three pills, at bed time, accord- 
ing to the requirements of the case. 

47. Sulphate of Iron, 1 scruple ; pulverized aloes, 2 scruples. Mix, and 
make into 20 pills. One pill twice a day. An excellent remedy, in chlorosis, 
when the bowels are confined. 

48. Carhonate of Iron, 1 dram ; pulverized rhubarb, J dram ; pulver- 
ized aloes, ^ dram ; extract of hops, ^ dram. Mix. Make 30 pills. One pill 
three times a day. 

49. Fluid Extract of Senna, 1 dram ; compound fluid extract of gentian, 
\ dram ; fluid extract of ginger, ^ dram ; aromatic spirits of ammonia, ^ dram. 
Mix. To be taken in a wine-glassful of sweetened water. 

50. Aromatic Syrup of Rhuharh, 1 oz. ; tincture of Colombo, 1 oz. Mix. 
Dose. — Two teaspoonfuls three times a day. 

51. Compound Infusion of Gentian, 6 ozs. ; epsom salts, 4 drams; diluted 
sulphuric acid, 16 drops. Mix. A table spoonful every six hours. 

52. Blue Pill, 10 grs.; pulv. gum arable, 5 grs.; magnesia, 1 dram; 
white sugar, 5 grs.; comp. infusion of gentian, 1^ ozs.; water, l^ozs. ; tinct. 
of ginger, li ozs. Mix. From a teaspoonful to a tablespoonful to be taken 
night and morning. 

53. Pulverized Peruvian Bark, 1 oz. ; pulv. rhubarb, \ dram ; pulv. muri- 
ate of ammonia, 1 dram. Mix. Divide into eight powders. Take one three 
times a day. 

54. Oxide of Zinc, 2 drams ; magnes., \ oz. ; quinine, 1 scruple. Mix.' 
Divide into 32 powders. Take one four times a day. 

55. Aloes, 1 oz. ; gentian, 1 oz. ; orange peel, 1 oz. ; juniper berries, 1 oz. ; 
aniseed, bruised, 1 oz. ; gin, 1 pint. Mix. Macerate two weeks, and strain. 
Dose. — A tablespoonful. Good for bilious habits. 

Carminative Physic. 

56. Manna, 1 oz. ; aniseed, bruised, 1 dram ; boiling water, J pint. Mix. 
Let the mixture stand for half an hour, then strain, and add three drams of 
carbonate of magnesia so as to make a perfect mixture. Take a wine-glass 
full every two or three hours, till it operates. For the drum-head state of the 
bowels. 

57. Thoroughwort, 2 ozs. ; ginger and cloves, each, \ oz. ; ext. dandelion, 
4 ozs.; water, 1^- pints. Boil to one-third, and add sugar, 1^ pounds, and 
brandy, ^ pint. An excellent cordial cathartic to act upon the liver. 



PRESCRIPTIONS.— RECIPES. 697 



Tonics. 

58. Chamomile Flowers, ^ oz. ; cold water, 1 pint. Macerate for one hour 
and strain. A wine-glassful to be taken several times a day. 

59. Sulphate of Quinine, 15 grains ; diluted sulphuric acid, 15 drops ; 
compound tincture of cardam., 3 drams ; tincture of hops, 3 drams ; compound, 
infusion of roses, 6 ozs. Mix. A teaspoonful two or three times a day, in 
chlorosis. 

60. Diluted Sulphuric Acid, 2 drams ; syrup of orange peel, 2 ozs. ; cinna- 
mon water, 1 oz. Mix. A teaspoonful or two in a wine-glass of water two 
or three times a day. 

61. Carbonate of Iron, 1 dram ; extract of gentian, 1 dram. Mix. Make 
30 pills. One pill two or three times a day. 

62. Sulphate of Quinine, 12 grains; aromatic sulphuric acid, 24 drops; 
syrup, 1 oz. ; peppermint water,/l oz. Mix. In intermittent fever, take one 
tablespoonful once in three hours. Ordinarily, one teaspoonful is a sufficient 
dose. 

63. Compound Infusion of Gentian, 8 ozs. ; nitro-muriatic acid, 30 drops. 
Mix. Take one tablespoonful three times a day. 

64. Bicarbonate of Soda, i oz. ; compound infusion of gentian, 4 ozs.; 
tincture of Colombo, 1 oz. ; syrup of orange peel, ^ oz. Mix. Take a table- 
spoonful three times a day. 

65. Sulphate of Quinine, 1 scruple ; alcohol, 4 ozs. ; sulphuric acid, 5 
drops ; Madeira wine, 1 quart. Mix. Two wine-glassfuls a day. 

66. Rasped Quassia, 2 drams ; cold water, 1 pint. Macerate twelve hours, 
and strain. 

67. Quinine, 1 scruple ; alcohol, 4 ozs. ; sulphuric acid, 5 drops. Mix. 
Take a teaspoonful three times a day. 

68. Arseniate of Iron, 3 grains ; extract of gentian, 2 drams ; pulver- 
ized liquorice, 1 dram. Mix. Make 20 pills. Take one pill three times a 
day. If the eye-lids become inflamed, discontinue for a few days, and then 
begin again. 

69. Soft Water, 3 ozs. ; quinine, 10 grains ; diluted sulphuric acid, 10 drops ; 
simple syrup, 1 oz. Mix. A teaspoonful every two or three hours. 

70. Quinine, 10 grains ; diluted sulphuric acid, 10 drops ; white sugar, 
4 drams ; cinnamon water, 4 ozs. ; tincture of kino, 2 drams. Mix. One tea- 
spoonful every three hours. 

71. Tartrate of Iron, 40 grains ; soft water, 2 ozs. ; syrup of ginger, \ oz. 
Mix. 20 to 40 drops every three hours. 

72. Prussiate of Iron, 4 scruples ; quinine, 4 scruples ; alcoholic ext. of 
black cohosh, 4 scruples. Mix. Make 48 pills. 

73. Rose Water, 6 ozs. ; syrup of orange peel, 1 oz. ; muriated tinct. of 
iron, 1 oz. Mix. For an adult, one teaspoonful in a wine-glass of water 
after each meal. 

74. Precipitated Carbonate of Iron, 30 drams ; ext. of conium, 15 drams j 

88 



698 PRESCRIPTIONS.— EECIPES. 

syrup of balsam of Tolu, 6 ozs. ; oil of cinnamon, 12 drops ; oil of lemon, 12 
drops ; alcohol, 2 ozs. ; water, 1 pint ; brandy, I pint ; loa^ sugar, 4 ozs. Mix. 
Give from one to three tablespoonfuls three or four times a day, in insanity. 

75. Citrate of Iron, 1 dram ; sulphate of quinine, 1 scruple ; ext. of nux 
vomica, 8 grs. Mix. Make 32 pills. One pill three times a day. 

76. Nitric Acid, ] dram ; hydrochloric acid, ^ dram ; comp. infusion of 
gentian, 1^ ozs. Mix. One teaspoonful in water is a dose. 

77. Sulph, Quinine, 1 dram ; tartaric acid, 6 grs. ; water, 1 drop. Mix. 
Make 30 pills. Dose. — One pill, to be repeated as often as needed. 

78. Diluted Nitric Acid, 4 drams ; diluted muriatic acid, 4 drams ; syrup 
of orange peel, 1 dram ; water, 1 ^- ozs. Mix. One teaspoonful in a wine- 
glass of water, taken before meals. 

General and Nerve Tonics. 

79. Valerianate of Quinine, \ dram ; ext. of black cohosh, 1 dram ; ext. 
of scuUcap, 1 dram. Mix. Make 60 pills. Take one pill every one, two, three, 
or four hours, according to the urgency of the case. 

80. Iron hy Hydrogen, 24 grs. ; sulphate of morphia, 1 gr. ; ext. of nux 
vomica, 5 grs. Mix. Make 24 pills. For an adult, one pill three times a day. 

81. Ext. of ScuUcap, 2 drams ; ext. of chamomile, 2 drams ; ext. of boneset, 
1 dram ; quinine, 1 dram ; pulv. cayenne, 1 scruple ; oil of valerian, i dram. 
Beat well together and make 90 pills. For an adult, one pill every two or 
three hours. 

82. White Vitriol, 1 dram ; ext. of nux vomica, 8 grs. Mix. Make 32 
pills. One pill three times a day. 

83. Strychnia, 2 grs.; ext. of aconite, 16 grs. ; ext. of hyoscyamus, 16 grs.; 
quinine, ^ dram. Mix. Make 32 pills. One pill three times a day. 

84. Citrate of Iron, 1 dram; trisnitrate of bismuth, 1 dram ;. sulphate of 
quinia, 1 scruple ; ext. of nux vomica, 6 grs. _ Mix. Make 32 pills. Take 
one pill three times a day. 

Nerve Tonics and Antispasmodics. 

85. Strychnine, 2 grs. ; ext. belladonna, 5 grs. ; alcoholic extract of black 
cohosh, 2 scruples. Mix. Make 40 pills. One pill four times a day. 

86. Strychnine, 2 grs.; diluted phosphoric acid, 1 oz. ; peppermint ^ater, 
3 pints. Dissolve the strychnine in the acid ; then add the peppermint water. 
A tablespoonful to be taken three times a day, in palsy, dyspepsia, neuralgia, 
and in most states of the nervous system requiring tone. Also in fever and 
ague. 

87. High Cranberry Bark, 1 oz. ; skunk cabbage root, ^ oz. ; scullcap, 
J oz. ; cardamom seeds, 2 drams ; pulv. cayenne, 2 drams. Put these to a pint 
of wine, shake well every day for three or four days. A tablespoonful four 
times a day. 

88. Distilled Water, 2 ozs. ; valerianic acid, 1 oz. ; subcarbonate of am- 
monia enough to neutralize the acid ; then add alcoholic ext. of valerian, 2 
scruples. A teaspoonful three times a day. For Neuralgia. 



PRESCRIPTIONS.— EECIPES. 699 

89. Ext, of Valen'an, 12 grs. ; ext, of hyoscyamus, 12 grs. ; oxide of 
zinc, 24 grs. jNIix. Make 12 pills. One pill twice a day. 

90. Sulphate of Morphia, 2 grs. ; cyanide of potassium, 4 grs. ; ext. of 
valerian, 4 grs. Make 24 pills. One pill three times a day. 

— 91. Ext. of Hyoscyamus, f dram; sulphate of morphia, 3 grs.; strych- 
nine, 2 grs. ; pulv. cayenne, ^ dram ; sulphate of zinc, 15 grs. Make 30 pills. 
Take one four times a day. Excellent in neuralgia. 

92. Ext. of Hyoscyamus, \ dram ; Talerianate of zinc, 1 scruple. Mix. 
Make 30 pills. Take one, two or three times a day, for neuralgia of the face. 

93. Ext. of Hyoscyamus, ^ dram ; valerianate of iron, 1 dram. Mix. 
Make 30 pills. Give from one to thi-ee a day. For neuralgia, in its various 
forms. 

94. Tinct. of Black Cohosh, 2 ozs. ; tinct. of scullcap, 2 ozs. Mix. One 
teaspoonful from two to five times a day. - 

95. Alcoholic Ext. of St. Ignatius's Bean, 30 grs. ; pulv. gum arable, 10 
grs. Make into 40 pills. Take one pill three times a day. 

96. Simple Syrup, 1 oz. ; prussic acid, 1 drop. Mix. A teaspoonful morn- 
ing and evening. If no dizziness or sickness is produced within forty-eight 
hours, repeat the dose three times a day. This is for a child six months 
old ; add one drop more of the acid for each additional year of the child's age. 

97. Comp. Pill of Galhanum, 1 dram ; comp. pill of valerian, 1 dram. Mix. 
Divide into 40 pills. One or two pills three times a day. 

98. Sulphate of Zinc, 1 dram ; comp. galbanum pill, ^ dram ; ext. of 
hyoscyamus, 1 scruple. Mix. Make 32 pills. One pill three times a day. 
For St. Vitus's dance. 

99. Dioscorein, 12 grs.; pulv. camphor, 4 grs.; pulv. cayenne, 12 grs.; 
white sugar, 1 scruple. Mix. Divide into four powders. Give one every 15 
minutes. 

100. Ext. of High Cranberry Baric, 1 scruple ; dioscorein, 1 scruple ; 
aletridin, 1 scruple ; pulv. cayenne, 1 scruple. Mix. Make 20 pills. Take 
one pill an hour after each meal. 

Alteratives and Tonics. 

101. Iodide of Potassium, 1 oz. ; compound infusion of gentian, or infusion 
of quassia, 6 ozs. Dose. — A tablespoonful, for secondary and tertiary syphi- 
lis, and other complaints. A teaspoonful for a child. 

102. Iodide of Iron, \ dram ; compound tincture of Colombo, 1 oz. ; pure 
water, 7 ozs. Mix. A tablespoonful three times a day. 

103. Syrup of Iodide of Iron, 1 oz. Thirty drops three times a day, in 
water. An excellent remedy in chlorosis, and all other low states of the blood 
connected with scrofula. , 

Expectorants and Cough Preparations. 

104. Tartar Emetic, 1 grain ; boiling water, 10 drams. Mix. Take one 
teaspoonful every two hours. 



700 PRESCRIPTIONS — RECIPES 

105. Infusion of Senega, 4 ozs. ; syrup of ipecac, 1 dram ; syrup of squills, 
3 drams ; tartar emetic, 1^ grains. Mix. A teaspoonful every ten minutes. 

106. Tincture of Lobelia, ^ oz. ; syrup of squills, ^ oz. Mix. Twenty 
drops four or five times a day for a child two years old. 

107. Peppermint Water, 6 ozs. ; epsom salts, 1 oz. ; tartar emetic, 1 grain. 
Mix. Two tablespoonfuls every four hours. 

108. Hydrocyanic Acid, 25 drops ; wine of ipecac, 2 drams ; syrup of 
tolu, 1 oz. ; soft water, 3 ozs. Mix. A teaspoonful four or five times a day. 
An excellent remedy in hooping cough. 

109. Tinct. Blood-root, 1 oz. ; laudanum, 2 drams ; wine of ipecac, 4 drams ; 
syrup of tolu, 2 ozs. Mix. Dose from 30 to 60 drops four times a day. 

110. Tinct. Blood-root, 1 oz. ; sulphate of morphia, 1^ grains; tinct. digi- 
talis, \ oz. ; wine of antimony, ^ oz. ; oil of wintergreen, 10 drops. Mix. Dose 
from 20 to 40 drops twice or three times a day. Excellent for a hard, dry 
cough. 

111. Tinct. of Lobelia, \ oz. ; tinct. of blood-root, 2 ozs. ; oil of spearmint, 
J dram ; molasses, 5 ozs. Take one-half a teaspoonful as often as needed. 

112. Syrup of Tolu, 1 oz. ; syrup of squills, \ oz. ; wine of ipecac, 2 drs. ; 
paragoric, 3 drs. ; mucilage of gum arable, 1 J ozs. Mix. Take a teaspoonful 
occasionally. 

113. Tinct. Blood Root, 2 drams ; syrup of tolu, 1 oz. ; mucilage of gum 
arable, 3 ozs. ; diluted hydrocyanic acid, 40 drops ; sulphate of morphia, 2 grs. 
Mix. Dose, from one to two teaspoonfuls. 

Carminatives. 

114. Bruised Cloves, 2 drams; boiling water, 1 pint. Macerate for two 
hours in a covered vessel, and strain. A wine-glassful to be taken occasion- 
ally. 

115. Comp. Tinct. of Cardamom, 2 ozs.; comp. tinct. of lavender, 2 ozs. ; 
comp. tinct. of gentian, 2 ozs. Mix. One teaspoonful at a time, as occasion 
may require. 

Narcotics and Anodynes. 

116. Extract of Hyoscyamus, 1 scruple ; gum camphor, 1 scruple ; Dover's 
powder, 1 scruple. IVIix, and make into 20 pills. Dose. — One twice a day, 
for painful menstruation. 

117. Powdered Camphor, 12 grains; powdered castile soap, 12 grains; 
powdered opium, 12 grains ; syrup, 2 scruples. Mix. Make into 12 pills. 
Take one every hour till the effects of opium are experienced. 

118. Laudanum, \ oz. ; wine of ipecac, ^ oz. ; spirits of nitric aether, ^ oz. 
Mix. One teaspoonful every hour, till narcotic effects are observed. 

119. Camphor, 2 drams; chloroform, 1 dram; the yolk of an egg. Mix, 
and rub together ; and then add, tincture of opium, 1 oz. ; aromatic spirits of 
ammonia, 1 oz. Mix well. Take one teaspoonful every hour until it proves 
anodyne. 

120. Camphor, ^ dram ; extract of opium, 6 grains ; mucilage of gum 
arable, 2 scruples. Make 10 pills. 



PRESCRIPTIONS. — RECIPES. 701 

121. Chloroform, 2 ounces; compound sulphuric ether, 2 ozs. ; laudanum, 
2 ozs. ; tinct. cayenne, 1^ ozs. ; hydrocyanic acid, diluted, ^ oz. Mix. Dose. 
— Half a teaspoonful every three hours till anodyne effects are experienced. 

122. Uxt. of Belladonna, 10 grs. ; hydrocyanic acid, 40 drops ; tinct. 
Colombo, 1 oz. ; simple syrup, 1 oz. ; soft water, 2 ozs. Mix. One teaspoonful 
three or four times a day. Excellent in gastralgia and irritable dyspepsia. 
Also in asthma. 

123. Ext. of Belladonna, 6 grs. ; pulv. ipecac, 10 grs. ; confection of roses, 
2 grs. Mix. Make 30 pills. Take 1 pill twice a day. 

Diaphoretics and Sedatives. 

124. Tinct. of American Hellebore, 1 dram ; tinct. of black cohosh, 2 ozs. 
Mix. Take one teaspoonful from three to six times a day. Excellent for 
Neuralgia. 

125. Pvlverized Gum Arabic, 1 scruple ; soft water, 2 ozs. ; sweet spirits of 
nitre, \ oz. ; tinct. of veratrum viride, 20 drops. Mix. Give half a teaspoon- 
ful every half hour. 

126. Pulv. Blood-root, 2 drams; pulv. golden seal, 2 drams; pulv. sumach 
berries, 2 drams ; pulv. bayberry bark, 2 drams. Mix. Make an infusion in 
a pint of hot water, and give a tablespoonful every half hour. To produce 
perspiration. 

127. Pidverized Camphor, 2 grs., pulv. nitrate of potash, 2 grs.; pulv. 
opium, 1 gr. Mix. Make two powders. Take one on going to bed, in 
rheumatism. 

Diuretics. 

128. Tincture of Digitalis, 1 oz. ; syrup of squills,! oz. Mix. Ten 
drops for a child 7 years old every four hours. 

129. Nitrate of Potassa, 2 scruples ; water, 1 quart. Mix. Flavor to 
suit. 

130. Infusion of Digitalis, 4 ozs.; acetate of potash, 2 drams; sweet 
spirits of nitre, 2 drams ; cinnamon Avater, 1 J ozs. Mix. A tablespoonful 
every four or five hours. 

131. Spirits of Minderervs, 2 ozs.; sweet spirits of nitre, 1 oz. Mix. 
Take one teaspoonful every three hours. 

Refrigerants. 

132. Cream of Tartar, 2 scruples ; water, 1 quart. Mix. Flavor to 
suit. 

133. Bicarbonate of Soda, 30 grains; water, 6 ozs. Mix. To this mix- 
ture add 25 grains of tartaric acid, and take the whole foaming. 

Stimulants. 

134. Muriate of Ammonia, 1 oz. ; soft water, 9 ozs. Mix. Take one 
table spoonful three or four times a day. 



702 PRESCRIPTIONS. — RECIPES. 

135. Aromatic Spirits of Ammania, 2 drams; ether, 1 dram; laudanum, 
20 drops ; spirits of camphor, 1 dram. Mix. Half a teaspoonful as often as 
required. 

Alteratives. 

136. Proto-iodide of Mercury, 10 grains ; extract of opium, 5 grains. Mix. 
Make 20 pills. Take one pill night and morning. 

137. Biniodide of Mercury, 5 grains ; extract of conium, 2 scruples. Mix. 
Make 20 pills. Take one piU night and morning. 

138. Compound Infusion of Sarsaparilla, 1 pint; iodide of potassium, 
^ oz. Mix. Take a teaspoonful after each meal. 

139. Compound Infusion of Sarsaparilla, 1 pint ; corrosive sublimate, 
4 grains. Mix. Take a teaspoonful four times a daj. 

140. Compound Infusion of Gentian, 4 ozs. ; iodide of potassium, ^ oz. 
Mix. One teaspoonful after each meal. 

141. Iodide of Arsenic, 5 grains ; soft water, 1 pint. Mix. One tea- 
spoonful three times a day. 

142. Blue Pill, 12 grains; pulverized ipecac, 3 grains; extract of hyos- 
cyamus, 4 grains. Mix. Divide into 12 parts, one to be given every thi'ee 
hours. 

143. Pulverized Blood Root, 1 scruple ; iodide of arsenic, 2 grs. ; ex- 
tract • of cicuta, 2 scruples. Mix. Make 40 pills. One piU three times a 
day. 

144. Iodide of Potassium, 1 dram ; water, \ oz. Mix. Thirty drops 
to a child 7 years old, every hour. 

145. ^Comp. Syrup of StiUingia, 1 pint ; iodide of potassium, 1 oz. IMix. 
A tablespoonful after each meal. 

146. Fluid Ext. of Sarsaparilla, 4 ozs.; fluid ext. of pipsissewa, 1 oz. ; 
water, 1 quart ; iodide of potassium, 2 ozs. Mix. Take a tablespoonfiil three 
times a day. 

147. Bicarbonate of Potassa, 3 drams ; water, 4 ozs. Mix. Add a table- 
spoonful of the solution to the same quantity of lemon juice, previously mixed 
with a tablespoonful of water. To be taken foaming, several times a day. 

148. Blue PiU, ^ dram; extract of henbane, 1 scruple. Make 10 pills. 
One pill at night. 

149. Mercury with Chalk, \ dram ; extract of conium, 1 scruple. Make 
into 8 pills. Take one pill night and morning. 

150. Corrosive Sublimate, 4 grains ; extract opium, 5 grains. Mix, and 
make into 20 pills. Take one piU night and morning. 

151. Iodide of Potassium, 1 dram ; syrup of sarsaparilla, 4 ozs. Mix. 
Take two teaspoonfuls three times a day. 

Astringents. 

152. Sugar of Lead, 2 scruples ; opium, 1 scruple ; conserve of red roses, 
1 scruple. Beat into a mass, which is to be divided into 30 piUs. Take one 
every hour, until narcotic effects are observed. 



PEESCRIPTIONS. — RECIPES. 703 

153. Dover s Poirdej-, J dram ; prepared chalk, 1 scruple. Mix, and divide 
into 12 equal powders. 

154. Chalk Mixture, 4 ozs. ; tinct. of catechu, \ oz. ; laudanum, 1 dram. 
Mix. Dose, in diarrhoea, two to four teaspoonfuls three times a day. 

155. Oil of Turpentine, 1 dram ; mucilage of gum arabic, 1 dram ; simple 
syrup, \ oz. ; cinnamon water, 2 ozs. Mix. To be taken at a draught. 

156. Sugar of Lead, 16 grains; prepared chalk, 1 dram; pulverized ipecac, 
4 grains ; pulverized opium, 2 grains. Mix. Divide into 1 6 portions, one to 
be given every three or four hours. 

157. Sugar of Lead, 8 grains ; vinegar, 8 drops ; white sugar, 1 dram ; 
soft water, 1 oz. Mix. A teaspoouful three or four times a day, until the dis- 
charges are abated. 

158. Prepared Chalk, i dram ; pulverized ipecac, 3 grains. Mix. Make 
12 powders. Give one, two or three times a day. 

159. Pidverized Catechu, 2 drams ; bruised cinnamon, -^ dram ; boiling 
water, 5 ozs. Steep in a covered vessel for one hour, and strain. A teaspoonful 
every two, three, or four hours, according to age, nature of the case, etc. 

1 60. Soft Water, 1 oz. ; sugar of lead, 5 grains ; vinegar, 6 drops ; loaf 
sugar, 3 drams. Mix. A teaspoonful every hour or two. 

161. Tinct. of Catechu, \ oz. ; laudanum, 2 drs. ; spirits of camphor, 2 drs.; 
tinct. of myrrhoe, 2 drs. ; tinct. of cayenne, 2 drs. Mix. Dose, from half a 
teaspoonful to a teaspoonful, for diarrhoea. 

162. Syrup of Orange Peel, 1 oz. ; acetate of morphia, 2 grs. ; tinct. of 
cinnamon, 6 drs. ; tinct. cardamom, 2 drs. Mix. Dose. — A teaspoonful. A 
valuable remedy in diarrhoea. 

Counter-irritants. 

163. Tincture of Spanish Flies, 1 oz. ; olive oil, 2 ozs.; alcohol, ^ pint. 
Mix. To be applied externally, watching the effect, so as not to produce a 
blister. 

164. . Water of Ammonia, 1 dram; olive oil, 1 oz. Mix. Apply to the skin. 

165. Mustard Powder, 1 tablespoonful. Mix with a little water to make 
a thick paste. Then spread upon a piece of brown paper or cotton cloth, 
and cover its surface with a piece of thin muslin to prevent the mustard from 
sticking to the flesh. Place it upon the sore or painful part, and keep it on 
fifteen or twenty minutes, or till a good degree of redness is produced. 

166. Vinegar of Spanish Flies, 1 oz. ; spirits of camphor, 1 oz. Mix. 
To be rubbed gently upon the skin. If applied freely, and rubbed thoroughly 
in, it may produce a blister. 

167. Yellow Wax, Rosin, Lard, each, 6 drams. Melt over a slow fire, and 
then stir in slowly, when at a very moderate degree of warmth, 1|- drams of 
pulv. Spanish flies, to make an ointment. 

168. Water of Ammonia, strong, 1 oz. ; alcohol, 1 oz. Mix. Wet a piece 
of cotton cloth, and lay it upon the painful part, and cover it with flannel to 
prevent evaporation. 



704 , PRESCRIPTIONS.— RECIPES. 



Ointments. 

169. Mercurial Ointment, 1 oz. ; extract of belladonna, 1 oz. ; extract of 
henbane, 1 oz. ; camphor, 10 grains. Mix. For external use. 

170. Extract of Belladonna, ^ dram ; lard, ^ oz. Mix. To be rubbed 
on the neck of the womb in painful menstruation. 

171. Prussic Acid, 2 drams ; sugar of lead, 1 dram ; cocoa-nut oil, ^ oz. ; 
lard, 1 oz. Make an ointment. 

172. Neapolitan Ointment, 2 drams ; extract of belladonna, 1 dram. IMix. 

173. Extract of Belladonna, 15 grains ; lard, 1 oz. Mix. 

174. Sulphur et of Lime, 1 dram; camphor, in powder, 15 grains; lard, 
1 oz. Make an ointment. 

175. Elder -Flower Ointment^ 1 oz. ; oxide of zinc, 1 dram. Make an 

ointment. 

176. Oxide of Zinc, 1 dram ; spermaceti ointment, 1 oz. Mix. 

177. Napihaline, 2 scruples ; lard, 1 oz. Make an ointment. To be 
spread upon linen, and applied to the diseased skin night and morning. 

178. Mild Nitrate of Mercury Ointment, 3 drams ; sugar of lead, 16 grains; 
rose-water ointment, 1 oz. 

179. Laudanum, \ dram ; sulphur, \ dram ; oxide of zinc, 1 dram ; oil of 
almonds, 1 oz. ; lard, 3 ozs. Make an ointment. 

180. Olive Oil, 4 ozs.; white wax, 2 drams. Melt these together, and 
then add honey, 2 drams ; croton oil, 20 drops. 

181. Elder-Flower Ointment, 1 oz. ; pulverized blue vitriol, 1 scruple. 
Make an ointment. 

182. Purified Beeves* Marrow, or lard, 6 drams ; oil of sweet almonds, 2 
drams ; pulverized Peruvian bark, 1 dram. Mix. 

183. Pulverized Sulphate of Copper, 10 grs ; extract of Spanish flies, 5 
grs. ; lard, 1 oz. Mix. Rub into the scalp. 

184. Lodide of Lead, 1 dram ; lard, 2 ozs. ISIix. To be rubbed on the 
surface. 

185. lodide of Potassium, 1 dram ; lard, 2 ozs. Mix. 

186. Basilicon Ointment, 1 oz. ; red precipitate, 1 dram. Mix. 

187. Lodide of Potassium, \ dram ; lard, 1 oz. Mix. 

188. Ver atria, 4 grs. ; lard, 5 drams. Mix. 

189. Tobacco Leaves (fresh and sliced), 10 ozs.; diluted acetic acid, 4 pints ; 
basilicon ointment, 13 ozs. Boil the tobacco in the acid, strain, and evaporate 
the decoction to six ounces. Add this to the basihcon ointment, heated, and 
stir till cold. For gathered breasts. 

Liniments. 

190. Sweet Oil, 1 oz. ; strong water of ammonia, 1 oz. IMix. To be 
rubbed on with a piece of flannel. 



PRESCRIPTIONS. — RECIPES. 705 

191. Lime Water, 2 ozs. ; flax seed oil, 2 ozs. Mix. Apply outwardly. 

192. Olive Oil 1 oz, ; solution of potassa, 2 drams; strong mercurial 
j ointnieut, 1 dram. Mix. 

193. Olive Oil 4 ozs.; oil of amber, 2 drams; oil of rosemary, 2 drams. 
Mix. 

194. Spirits of Turpentine, 1 oz. ; linseed oil, 1 oz. ; lime water, 1 oz. 
Mix. For external use. 

19."). Oil of HemJoch, 2 drams; oil of origanum, 1 dram; camphor, 1 dram; 
opium, 1 dram ; alcohol, 4 ozs. Mix. 

196. Soap Liniment, 2 ozs.; chloroform, 1 dram. Mix. 

197. Tinct. of Aconite-root, ^ oz. ; opium liniment, \ oz. Mix. For neu- 
ralgia, etc. Apply a tea-spoonful to the painful part. 

198. White Soap, 12 ozs. ; camphor, 6 ozs. ; oil of rosemary, 1^ ozs. ; alco- 
hol, 4 pints ; opium, 3 ozs. Mix and filter. An excellent liniment, acting 
at times like a charm in the removal of local pains. 

199. Sulphuric Acid, 1 dram ; spirits of turpentine, 1 dram ; olive oil, 
3 drams. Mix the oil and spirits of turpentine first, then gradually add the 
sulphuric acid. A valuable liniment for chilblains. To be rubbed on two or 
three times a day. 

Washes, Lotions, Gargles, etc. 

200 Bruised White Oak Bark, 1 oz. ; water, 1^ pints. Boil down to a 
pint, and strain. To be used as a wash. 

201. Borate of Soda or Borax, 2 drams ; water, 4 ozs. Mix. To be used 
as a lotion. 

202. Alum, 2 drams ; water, 4 ozs. Mix. To be used as a lotion. 

203. Tannin, 1 scruple ; water, 4 ozs. Mix. For external use. 

204. Bihorate of Soda, \ oz. ; rose water, 6 ozs. ; sulphate of morphia, 
6 grains. Mix. To be used as a wash in itching of the female privities. 

20.5. Chlorinated Soda, 1 oz. ; water, 12 ozs. Mix. Rinse the mouth with 
it two or three times a day, but do not swallow. 

207. Rose Water, 5 ozs. ; sugar of lead, 8 grains ; sulphate of zinc, 8 grs. 
Mix. 

208. Bose Water, i^ ozs. ; nitrate of silver, 2 grains. Mix. 

209. Sulphate of Zinc, 8 grains ; tannin, 1 scruple ; water, 5 ozs. Mix. 

210. Chloride of Zinc, 6 grains ; soft water, 2 ozs. Mix. 

211. Nitrate of Silver, 10 grains ; soft water, 1 oz. Mix. 

212. Corrosive Sublimate, 5 grains ; soft water, 1 pint. Mix. 

213. Alcohol, 1 pint; soft soap of potash, 1 pint. Dissolve and filter, then 
add oil of citron, 1 oz. Mix. It will answer a good purpose if the oil of 
citron be omitted. 

214. Nitrate of Silver, 2 scruples ; nitric acid, 12 drops ; soft water, 1 oz. 
Mix. Apply with a piece of lint tied to the end of a stick. 

89 



706 PRESCRIPTIONS. — RECIPES. 

215. Copperas, 1 oz. ; soft water, 1 pint. Mix. 

216. Alcohol, 1^ ozs. ; rose water, 4 ozs. Mix. 

217. Corrosive Sublimate, 6 grains ; spirits of rosemary, 1 oz. ; alcohol, 

1 oz. ; emulsion of bitter almonds, 6 ozs. Mix. 

218. Solution of Sugar of Lead, 12 drops ; laudanum, 1 dram ; water, 4 ozs. 
IVIix. To be applied externally only. 

219. Nitrate of Silver, 1^ drams ; soft water, 1 oz. Mix. 

220. White Vitriol, 1 dram ; rose water, 3 ozs. Mix. Apply outwardly. 

221. Hydrocyanic Acid, 4 drams ; sugar of lead, 15 grains ; alcohol, 4 
drams ; water, 7 ozs. Mix. Apply externally. 

222. Corrosive Sublimate, 5 grains ; almond mixture, ^ pint. JVIix. Apply 
externally. 

223. Rose Water, 4 ozs. ; pulverized borax, ^ oz. ; sulphate of morphine, 
6 grains. Mix. To be appUed to the parts many times a day. 

224. Sugar of Lead, 2 drams ; laudanum, 1 dram ; soft water, ^ pint. 
Mix. For external use. 

225. Corrosive Sublimate, 5 grains ; cologne, 2 ozs. ; soft water, 6 ozs. 
Mix. For external use only. 

226. Acid Nitrate of Mercury, 1 dram; soft water, 4 ozs. JVIix. Apply 
every second day. 

227. Sugar of Lead, 3 grains ; soft water, 1 oz. Mix. As a wash in 
inflammation of the mouth in infants. 

228. Mucilage of Gum Arabic, 1 oz. ; syrup of orange peel, J oz. ; chloride 
of lime, 15 grains. Mix. 

229. Decoction of Peruvian Baric, 3 ozs. ; syrup of orange peel, 1 oz. ; 
chloride of soda, 1 oz. Mix. 

230. Creosote, 4 drops; mucilage of gum arable, \ oz. ; camphor water, 
8 ozs. Mix. 

231. Vinegar, 1 dram; alcohol, 3 drams ; simple syrup, 1 oz. ; water, 3 ozs. 
IVIix. 

232. White Oak Baric, 1 oz. ; water, 1 pint. Boil away one quarter, and 
strain ; then add alum, 1 scruple. Apply to the parts with a soft sponge, or 
dossil of lint, several times a day. 

233. Hydrochloric Acid, \ dram; honey, 1 oz. ; rose water, 1 oz. Mix. 
Apply three or four times a day. 

234. Sulphate of Copper, \ dram ; soft water, 1 oz. Mix. To be ap- 
plied twice a day to the ulcers in gangrene of the mouth. 

235. White Vitriol, 1 dram ; soft water, 2 drams. Mix. Then add honey, 

2 drams ; tincture of myrrh, 2 drams. To be apphed twice a day to the ulcers 
in gangrene of the mouth. 

236. Creosote, 1 dram ; alcohol, 1 dram. Mix. To be applied, with a 
camel's hair pencil, to the gangrenous ulcers of the mouth after running a 
lancet through the sloughs. 

237. Acid Nitrate of Mercury, \ dram ; soft water, 1 oz. Mix. To be in- 
jected into the throat with the shower syringe, or appUed to ulcers with a penciL 



PRESCRIPTIONS. — RECIPES. 707 

238. J^ose Water, 4 ozs. ; sugar of lead, 2 drams. Mix. For external 
use. 

239. Rose Water, 2 ozs. ; sugar of lead, 1 scruple. Mix. For external 
use. 

240. Tincture of Arnica, ^ oz. ; cold water, 4 ozs. Mix. For external 
use. 

241. Tinct. Blood-root, 2 ozs.; solution chloride of Soda, 2 ozs.; tinct. 
henbane, 2 ozs. Mix. 

242. Bucket of Warm Water ; cayenne pepper, pulverized, 1 tablespoonful ; 
ground mustard, 2 tablespoonfuls. Mix. As a foot bath in suppression, etc. 

243. Chlorate of Potash, J oz. ; strong hydrochloric acid, 40 drops ; water, 
1 pint. Mix. An excellent wash for chronic fetid ulcers, — soon converting a 
foul ulcer to a healthy-looking one. A good gargle. 

244. Powdered Golden Seal, 1 dram ; powdered cranesbill, 1 dram ; pow- 
dered witch-hazel bark, 1 dram. Mix. Pour upon these half a pint of boiUng 
water. Let them stand till cold. To swab an ulcerated throat in scarlet fever, 
and for other purposes. 

245. Pidv. Cayenne, 1 dram ; salt, 1 dram ; boiling water, 1 gill. Mix, and 
let them stand fifteen minutes. Then add one gill of vinegar. Let them stand 
an hour, and strain. Put a teaspoonful in a child's mouth once an hour, in ma- 
lignant scarlet fever. 

Injections. 

246. Castor Oil, 1 gill; pulv. cayenne, 10 grs. ; molasses, 1 gill; table 
salt, 1 teaspoonful ; warm water, 1 pint. Mix. 

247. Senna Leaves, 2 drams. Steep in a pint of water. Then add one 
ounce of epsom salts, and strain. A quarter of this may also be taken as a 
brisk purge. 

248. Castor Oil, 2 ozs. ; tinct. prickly ash bark, \ oz. ; comp. tinct. of 
Virginia snake root, 2 drams ; infusion of boneset and senna, equal parts, ^ pint. 
Mix- 

249. Castor Oil, 1 oz. ; salts of tartar, ^ oz. ; warm water, 1 pint. Mix. 

250. Epsom Salts, 1 oz. ; senna leaves, ^ oz. ; pulv. cayenne, 10 grs. ; 
boihng water, 1 pint. Let the water stand upon the senna and cayenne 15 
minutes. Then pour it off, and add the salts. 

251. Thoroughwort, 1 oz. ; senna, 1 oz. ; lobelia, \ dram ; cayenne, 10 
grs. ; common salt, 1 table-spoonful ; molasses, \ pint ; boiling water, 1 pint. 
Make a strong decoction of the herbs, and then add the salt and molasses. 

252. Wine of Ipecac, 1 oz. ; spirits of turpentine, 1 oz. ; castor oil, 1 oz.; 
molasses, \ pint ; warm water, ^ pint. Mix. 

253. Flax Seed Tea, J pint ; laudanum, 40 drops. Mix. 

254. Nitrate of Silver Crystals, 10 grains ; corrosive sublimate, 5 grs. ; 
sugar of lead, 1^ drams ; white vitriol, IJ drams; soft water, 6 ounces. Mix. 
An injection for certain forms of whites, etc. 

255. Bruised Galls, \ oz. ; two large poppy heads ; water, 1 pint. Boil a 
quarter of an hour, and strain. For piles. 



708 PKESCRIPTIONS — RECIPES. 

256. Common Salt, 1 oz. ; chamomile flowers,^ oz. ; pulv. aloes, 1 dram. 
Boil the chamomile and aloes five minutes, in one pint of water, then strain, and 
add the salt. 

Hair Oils, Washes, etc. 

257. Cologne, 2 ozs. ; tincture of Spanish flies, 2 drams ; oil of rosemary, 
10 drops ; oil of lavender, 10 drops. Mix. Apply cautiously. If soreness 
of the scalp is produced, omit for a short time. 

258. Castor Oil, 2^ pounds ; strongest alcohol, 2 J pints ; pulv. Spanish 
flies, J oz. ; oil of burgamot, 2h ozs. ; otto of roses, 20 drops. Mix. Let them 
stand for a few days, and filter. A superior preparation for keeping the hair 
from falling, and to prevent dandruff. 

259. Tinct. Benzoin, camp., 2 drams ; tinct. Spanish flies, 2 drams ; castor 
oil, 6 ozs.; oil burgamot, 1 dram; oil of cassia or verbena, 15 drops; strong 
alcohol, 9^ ozs. Mix. As a hair wash, better even than the 9,bove. 

260. Slaked Lime, 2 drams ; bicarbonate of soda, 3 drams ; lard, 2 ozs. 
Mix. 

261. Slaked Lime, 1 oz. ; bicarbonate of potassa, 2 ozs. ; charcoal in pow- 
der, 1 dram. Mix. Apply to the parts, and wash off when dry. Keep in 
well stopped bottles. 

262. Slaked Lime, 4 ozs.; orris powder, 1^ ozs. Mix. Apply to the 
parts, and wash off when dry. 

263. Spanish White, \ pound; litharge, \ pound; slaked lime, ^ pound. 
Mix. Pulverize in a mortar. To be kept dry. When used, mix with water 
to a paste the thickness of cream. Spread on the hair and lay over it a wet 
cloth over night. 

264. Sulphur, 1 oz. ; sugar of lead, 1 oz. ; rose water, 4 ozs. Mix. Ap- 
ply to the hair. 

265. Nitrate of Silver, 1 dram ; nitric acid, 1 dram ; soft water, 1 pint ; 
sap green, 3 drams ; pulverized gum arable, 1 dram. Mix. Keep well corked. 

266. Hydrosul'phuret of Ammonia, 1 oz. ; liquor potassa, 3 drams ; soft 
water, 1 oz. Mix. Apply this with a tooth brush 15 or 20 minutes. Then 
brush the hair over with the following : — nitrate of silver, 1 dram ; soft water, 
2 ozs. ; using a clean comb to separate the hair. 

Miscellaneous. 

267. M^ine of Spurred Rye, 2 ozs. Dose. — One teaspoonful three times 
a day. For profuse menstruation from a relaxed state of the womb. 

268. Sulphate of Iron, 1 dram; sub-carbonate of potash, 1 dram. Mix, 
and make into 38 pills. One pill twice a day, and gradually increasing to four 
a day, in chlorosis. 

269. Sulphate of Iron, 1 dram; extract of hops, 15 grains; extract of 
poppies, 15 grains ; oil of cinnamon, 15 drops. Mix, and make into 24 pills. 
One pUl two or three times a day. 

^ 270. Oxide of Zinc, 2 drams ; ext. of cicuta, 2 scruples. Mix. Make 
48 piUs. 



PRESCRIPTIONS. — RECIPES. 709 

271. Pulverized Savin, 1 scruple; sulphate of copper, 1 scruple. To be 
sprinkled on venereal lumps or tumors, called condylomata, on the female geni- 
tals, or elsewhere. 

272. Balsam of Copaiva, 1 oz. ; oil of cubebs, 2 drams ; laudanum, 1 
dram ; mucilage of gum arable, 2 ozs. ; sweet spirits of nitre, ^ oz. ; compound 
spirits of lavender, 3 drams ; camphor water, 4 ozs. ; white sugar, 2 drams ; 
oil of partridge-berry, 5 drops. Mix. Take a table-spoonful three or four 
times a day. For gonorrhoea. 

273. Balsam of Copaiva, 1 oz. ; pulverized cubebs, 2 ozs. ; essence of pep- 
permint, 30 drops. Make a thick paste, hke dough. 

274. Pulverized Borax, 1 oz. ; pulverized white sugar, 1 oz. Mix. A little 
to be dissolved on the tongue. 

275. Pulverized Borax, ^ oz. ; honey, 4 ozs. Mix. 

276. Hydrochloric Acid, 1 dram ; honey, 1 oz. Mix. For touching large 
curdy patches in sore mouth of children. 

277. Pulverized Ipecac, 3 grains ; precipitated sulphur, 2 scruples ; extract 
of hyoscyamus, 6 grains. Mix. Divide into 12 parts. One to be taken every 
three or four hours. 

278. Pulverized Belladonna-root, 5 grains ; compound ipecac, powder, 10 
grains ; precipitated sulphur, h dram ; white sugar, 2 scruples. Mix. Make 
20 powders. One every three hours to a child two years old. 

279. Pulverized Alum, 25 grains ; extract of cicuta, 12 grains ; syrup of 
red poppies, 2 drams ; spearmint water, 3 ozs. Mix. A dessert-spoonful every 
six hours for a child two or three years old. 

280. Camphor, 1 dram ; sulphuric ether, 1 oz. Mix. Ten drops every 
half hour. 

281. Pulverized Rhuharh, 1 scruple ; mercury with chalk, 10 grains ; 
aromatic powder, 5 grains. Mix. Divide into 10 powders. One every four 
or five hours. 

282. Pulv. Blood-root, \ to 1 oz. ; chloride of zinc, ^ to 2 ozs. ; water, 
2 ozs. Add enough wheat flour to make a paste as thick as molasses. 

283. Sal. Volatile, ^ dram ; camphor water, 1 oz. Mix. 

284. Tinct. of Poison Oak, \ oz. ; tinct. aconite, 2 drams ; volatile tinct. 
of guaiacum, 2 drams. Mix. Thirty drops every three hours. 

285. Tinct. of Black Cohosh, 2 ozs. ; tinct. of digitalis, 2 drams. Mix. 
One teaspoonful from two to five times a day. 

286. Barberry Bark, 1 oz. ; sheep laurel leaves, 1 oz. ; wild cherry bark, 
1 oz. ; bitter-root, 1 oz. Mix. Infuse for several hours in 4 pints of cider. 
One tablespoonful three or four times a day. 

287. Horse Radish Root, 1 oz. ; bayberry bark, 1 oz. ; barberry bark, 
1 oz. ; wild cherry bark, 1 oz. ; prickly ash bark, 1 oz. Reduce the whole to a 
coarse powder, and infuse for several hours in 4 pints of cider. A tablespoon- 
ful three or four times a day. 

288. Mercury, 95 parts ; balsam of storax, 48 parts ; diacalon plaster, 312 
parts; wax, rosin, turpentine, each, 16 parts; ammonia, bdellium, each, 5 parts; 
olibanam and myrrh, each, 5 parts ; saffron, 3 parts ; spirits of lavender, 2 parts. 
Mix, and spread. 



710 PRESCRIPTIONS. — KECIPES. 

289. Populin, 20 grs. ; sanguinarin, 10 grs. ; pulv. white sugar, 30 grs. 
Rub well together, and divide into 16 powders. Take one four times a day. 
At the same time use prescription 73. 

290. Ptelein, 24 grs. ; hydrastin, 24 grs. ; ext. of belladonna, 3 grs. ; ext. 
of nux vomica, 2 grs. Mix. Make 24 pills. Take one three times a day. 

291. Strychnia^ 2 grs.; pulv. cantharides, 4 grs.; pulv, arnica leaves, 
1 dram. Mix. Divide into 32 powders. One to be taken three times a day. 

292. Wine of Colchicum Seeds, 1 oz. ; fluid ext. of dandelion, 1 oz. IVIix. 
One teaspoonful three times a day. 

293. Willow Bark, 1 oz. ; boiling water, 1 pint. Boil for ten minutes, and 
strain. Dose. — A wine-glass fuU once in three hours. 

294. Canada Balsam, 1 dram ; slaked lime, 1 dram. Mix, to form a 
paste. An excellent remedy for tooth ache, when pressed into the cavity. 

295. Tinct. Black Cohosh, 1 oz. ; iodide of potassium, 2 drams ; syrup of 
ipecac, 1 oz. ; spring water, 2 ozs. Mix. A teaspoonful three or four times a 
day, in rheumatism and cell-dropsy. 

296. Tinct. Black Cohosh, 1 oz. ; tinct. myrrh, 6 drams ; laudanum, 1 
dram ; tinct. cayenne, 1 dram. Mix. Take 30 or 40 drops four times a day, 
for dropsy. 

297. Solution Chloride of Soda, 6 drops ; water, 2 ozs. Mix. To be 
taken at a draught. A sure remedy for offensive breath from deranged stom- 
ach. 

298. Cream of Tartar, \ oz. ; fresh lemon peel, bruised, 4 ozs. ; Loaf 
sugar, 4 ozs. ; boiling water, 3 pints. Mix, and, after standing a while, strain. 

299. Citric ^c/c?, ^ dram ; bi-carbonate of potassa, -|- dram; lemon syrup, 

1 oz. ; soft water, 6 ozs. ; epsom salts, 1 oz. Mix. Two table spoonfuls, to be 
repeated every four hours, if necessary. 

300. Hard Wood Ashes, 1 quart ; common soot, -J gill ; water, 6 pints. 
Digest, settle, and filter. Take one tablespoonful three times a day, in acidity 
of stomach. 

301. Peppermint Water, 1|- ozs. ; wine of colchicum-root, ^ oz. ; sulphate 
of morphia, 1 gr. ; magnesia, 1 scruple. Dose. — One teaspoonful three or 
four times a day. Excellent for rheumatism. 

302. Cream of Tartar, 1^ ozs. ; sulphate potassa, J oz. ; pulv. squills, 

2 drs. ; tartar emetic, 2 grs. A teaspoonful of this mixture to be taken four or 
five times a day, in dropsy. 

303. Pulv. Alum, ^ dram ; white precipitate, 1 grain. Eub these well to- 
gether, and place the powder in a bottle; then add 1^ drams of glycerine. 
Shake the bottle until the mixture is of the consistence of cream, and repeat the 
shaking whenever it is about to be applied to the skin. For external use in 
erysipelas. 

304. Copaiva, 5 drams ; yolk of one egg ; gum of extract of opium, one 
grain ; water 7 ounces. Mix. To be used as an injection several times a day in 
gonorrhoea. 

305. Tannin, 3 grains ; ext. belladonna, f grain ; ext. conium, 2^ grains ; 
infusion of senna, 3 ozs.; fennel water and syrup of marshmallow, each 1^ ozs. 
Mix. A tablespoonful to be taken every two hours, in chronic bronchitis, and 
other complaints. 



PRESCRIPTIONS.— RECIPES. 711 

306. Glycerine^ 1 dram ; tannin, 1 dram. Dissolve the tannin in the gly- 
cerine. Excellent for sore nipples, and for chaps and excoriations generally. 

307. CoUodion^ 1 oz. ; venice turpentine, ^ oz. ; castor oil, 2 drams. Mix. 
To be applied outwardly, for chilblains and chaps. For cancer, manganic acid. 
^Not as painful as other caustics. 

308. Sulphate of Copper, 2 grains ; wine of opium, 1 dram ; soft water 2 
drams. Mix. Apply freely with a soft camel hair brush, three times a day, for 
purulent ophthalmia. 

309. Pure Acetic Acid, 2 drams ; soft water 3 ozs. ; simple syrup, 3 drams. 
Mix. A teaspoonful is to be taken every three hours, in scarlet fever, at the 
same time using sheet baths with tepid water. 

310. Compound tincture of Peruvian Bark, 4 ozs. ; citrate of iron 44 grains ; 
citric acid, 20 grains. Dissolve the citric acid in the tincture, and then the 
citrate of iron. After a few days, filter. Dose, one to two teaspoonfuls. 

311. No. 1. Gallic acid, 10 grains ; .dissolve in alcohol, 2 drams ; water, 6 
dram?:. No. 2. Crystals of Nitrate of Silver, \ dram ; water \ oz. Dissolve 
and add strong liquor of ammonia, till it becomes clear ; then add powdered gum 
arable, and dilute, if necessary, to 6 drams. This will color black ; to color 
brown, reduce it. An excellent hair-dye. Use the common directions, where 
there is a No. 1 and No. 2. 

312. Epsom Salts, 2 drams ; magnesia, 1 scruple ; syrup of ginger, 1 dram ; 
spearmint water, 11 drams. Mix. To be taken at a draught. This will be 
retained by the stomach, when most other things are rejected. 

313. Diluted Nitro-Muriatic Acid, 2 drams ; sweet spirits of nitre, 2 drams ; 
simple syrup, \ oz., water 1\ ozs. IVlix. Two tablespoonfuls are to be taken 
three times a day. Excellent in dyspepsia, with nasty tongue, and inactive 
liver. 

314. Pose Leaves, 1 scruple ; boiling water, 8 ozs. ; diluted nitric acid, 2 J 
drams. Mix. After standing half an hour, strain, and use as a wash for ulcers. 

315. White Vitriol, 1 dram ; water, 1 pint. Mix. To be used as a wash for 
ulcers, etc. 

316. Citrate of Iron and Strychnine, 1 dram ; syrup of orange peel, 2 ozs. ; 
soft water, J pint. Mix. Give one teaspoonful three times a day in neuralgia, 
and in other cases in which a nerve tonic is needed. 

317. Aloes and Soap Pill, 10 grains. Divide into two pills ; or, compound 
pill of aloes, 10 grs. Divide into two pills. 

318. Compound Colocynth Pill, 2 J scruples ; castile soap, 9 grs. ; oil of anise, 
2 drops. Mix, and make 12 pills. Two to be taken at bed-time. 

319. Compound tincture of Senna, 2 drams; epsom salts 2 drams ; diluted 
sulphuric acid, 8 drops ; spirits of nitric ether, ^ dram ; infusion of rhubarb, 10 
drams. IVIix. To be taken at a draught. 

320. Sulphate of Iron, 2 grs. ; epsom salts, 2 scruples ; diluted sulphuric acid, 
10 drops; compound tincture, 1 dram; syrup of poppies, \\ drams; pimento 
water, 9 drams. To be taken at a draught twice a day. 

321. Pulverized Rhubarb, 12 grains ; carbonate of magnesia, 10 grains ; aro- 
matic spirit of ammonia ^ dram ; syrup of ginger, 1 dram ; spearmint water, 10 
drams. Mix. To be taken at a draught. 

322. Comp. infusion Senna, 5 drams; infusion rhubarb, 5 drams; comp 



712 PRESCRIPTIONS.— RECIPES. 

tincture cardamom, ^ dram ; syrup, l^^ drams. Mix. To be taken at a draught, 
by dyspeptic persons. 

323. Carbonate of Soda, 10 grs. ; aromatic spirit of ammonia, \ dram ; tinc- 
ture of orange peel, 1 dram ; syrup of orange peel, 1 dram ; compound infusion 
of gentian, 10 drams. Mix. To be taken at a draught twice a day. 

324. Trisnitrate of Bismuth, 1 dram ; comp. tragicanth powder, 2 drams ; 
compound tincture cardamom, i ounce ; tincture of ginger, i- ounce ; spearmint 
water, 7 ounces. Mix. Two tablespoonfuls to be taken twice a day, in dyspepsia. 

324. Trisnitrate of Bismuth, 6 grs. ; bicarbonate of soda, 6 grains; pulver- 
ized cayenne, 1 grain. Mix. This quantity to be taken twice a day, in dyspep- 
sia, with acidity of the stomach. 

325. Solution of Acetate of Ammonia, \ ounce ; tincture of orange peel, 1 
dram ; syrup of orange peel, 1 dram ; tincture of cayenne, 20 drops ; comp. infu- 
sion of orange peel, 6 drams. Mix. The whole to be taken to relieve head- 
ache, after intoxication. 

326. Magnesia, 15 grains; solution of potassae, 15 drops ; comp. tincture of 
senna, 1 dram ; comp. infusion of senna, 6 drams ; syrup of ginger, 1 dram ; 
comp. infusion of orange peel, \ ounce. Mix. Taken at a draught, as an 
aperient, in sick and billious headaches. 

327. Aromatic Spirit of Ammonia, 1 dram ; tincture of columbo, 1 dram ; 
infusion of columbo, 10 drams ; syrup of poppies, 1 dram. Mix. To be taken 
at a draught, three times a day. 

328. Diluted Sulphuric Acid, 15 drops ; diluted hydrochloric acid, 10 drops ; 
tincture of orange peel, 1 dram ; comp. infusion of gentian, 6 drams ; syrup of 
poppies, 1 dram. To be taken at a draught, three times a day, half an hour 
before meals. 

329. Diluted Nitric Acid, 12 drops ; diluted hydrochloric acid, 8 drops ; in- 
fusion of cascarilla, 11 drams; syrup of poppies, 1 dram. Mix. To be taken 
at a draught, twice a day. 

330. Blue Pill, 4 grs. ; comp. pill of rhubarb, 4 grs. ; ext. hyoscyamus, 2 grs. 
Mix. Make two pills ; one pill to be taken at night. 

331. Ext. Hyoscyamus, 2^ grs. ; pulv. camphor, 2J grs. Mix. Make two 
pills ; one to be taken when the pain is most severe, in nervous headache. 

332. Comp. Tragacanth Powder, 8 grs. ; oil of lemon, 3 drops ; camphor 
water, 11 drams ; comp. tinct. cardamom, ^ dram; tinct. hyoscyamus, \ dram; 
chloroform, 15 drops. Mix. 

333. Tinct. Hyoscyamus, \ dram ; aromatic spirit of ammonia, \ dram ; syrup 
of orange peel, ^ dram ; peppermint water, 10 drams. Mix. In nervous and 
hysterical cases. 

334. Soap Liniment, 2| ozs. ; liquor ammonia, \ dr. ; laudanum, \ oz. Mix. 
Make a liniment. 

335. Comp. Pill of Colocynth, 7 grs. ; ext. of colchicum, 2 grs. ; oil of cara- 
way, 1 drop. Mix, and make two pills. To be taken at bed-time in rheumatic 
headaches. 

336. Chloride of Zinc, 6 ozs.; pulv. bloodroot, 2 ozs. ; myrtle wax, 1 oz. ; 
water of extract of opium, 6 drams ; extract of conium, 6 drams. Mix, and 
make an ointment. 



PRESCRIPTIONS.— RECIPES. 713 

337. Iodide of Lead, 1 scruple ; glycerine, 1 dram ; spermaceti ointment, 2 
ozs. Make an ointment. 

338. Bhuharh Pulv. \ oz. ; peppermint herb, pulv. \ oz. ; pulv. cinnamon, \ 
oz. ; pulv. bicarbonate of potassa, \ oz. ; pulv. wild cherry bark, i oz. Mix, and 
pour on one quart of hot water. Let this stand till cold, and add half a pint of 
brandy. Dose, half a wineglassful. 

339. Ext. Belladonna, 6 grains ; pulv. ipecac, 10 grains ; confection of roses, 
2 grains. Mix. Make 30 pills, one pill to be taken twice a day. 

340. Dioscorein, 1 2 grains ; pulv. camphor, 4 grains ; pulv. cayenne, 1 2 grains ; 
white sugar, 1 scruple. IMix. Divide into four powders. Give one every fifteen 
minutes. 

341. Leptandrin, 12 grains ; geranium, 12 grains ; myricin, 12 grains. Mix. 
Divide into twelve powders, of which one may be given three or four times a 
day. 

342. Quinine, \ dram; pulv. catechu, 1 dram ; pulv. opium, 15 grains. Mix. 
Make 32 pills. Give one pill three times a day. 

343. Compound Syrup of Rhubarb and Potassa, 4 ozs. ; tincture of prickly 
ash berries, 1 oz. ; essence of peppermint, 1 dram ; paregoric, 4 drams. Mix. 
A tablespoonful should be given every hour until it operates gently on the 
bowels. 

344. Pulv. Camphor, ^ dram ; pulv. opium, 16 grains ; pulv. cayenne, \ dram. 
Mix. Make 16 pills ; one every hour, in cholera. 

345. Rhubarb, 4 ozs. ; black cohosh root, 2 ozs. ; wild cherry bark, 2 ozs. ; 
geranium, 2 ozs., coarsely powder them, and mix. Add two pints of brandy 
and two pints of water. Let the mixture stand five or six days, stirring often, 
and then strain. Add four pints of water to the dregs, boil slowly to two pints, 
strain, and add to this the previous tincture. Sweeten with loaf sugar. Take 
a tablespoonful every one, two, or three hours. 

346. Beth Root, 1 oz. ; geranium, 1 oz. ; blackberry root, 1 oz. ; wild cherry 
bark, 1 oz. ; cinnamon, 1 oz. Powder the whole, and add to them \\ pints 
brandy, and 1^ pints water. Let them stand several days, stirring frequently. 
Add sweetening if preferred. Dose. One or two teaspoonfuls every two or 
three hours. 

347. Raspberry Leaves, 1 oz. ; geranium, 1 oz. ; blackberry root, 1 oz. ; lep- 
tandra root, 1 oz. Mix, and make three pints of strong decoction. Dose. A 
teaspoonful every hour. Suitable for a gargle. 

348. Sugar of Lead, 24 grains ; vinegar, 1 dram ; syrup of poppies, 1 
oz. ; rose water, 3 ozs. ; soft water, 4 ozs. Mix. Dose, one or two table- 
spoonfuls. 

349. Potassio-tartrate of iron, ^ oz. ; syrup of orange peel, 1 oz. ; water, 4 
oz. Mix. Take two teaspoonfuls three times a day. 

350. Geranium, golden seal, marshmallow, wild indigo root, rosemary, each 
half an ounce. Mix, and make one pint of strong infusion. After straining, 
add two drams powdered borax, and one gill of honey. An excellent astringent 
gargle. 

351. Dover's Powder, 15 grains; leptandrin, 5 grains. Mix. Divide into 
ten powders. One every three hours, for a child. 

90 



714 



PRESCRIPTIONS.— RECIPES. 



352. Dover's Powder, 15 grains , calomel, 5 grains. Mix. Divide into ten 
powders. Give one every three hours to a child in croup. 

353. Hydrochlorate of ammonia, ^ oz. ; diluted acetic acid, \ oz. ; alcohol, \ 
oz. ; camphorated mixture, 15 ozs. Mix. A good scattering wash for hydro- 
cele, etc. 

354. Chloride of soda, nitrate of potash, and hydrochlorate of ammonia, 
equal parts, and water enough to dissolve them. Mix. An excellent freezing 
mixture. 



PROXOUNCING DICTIONARY. . . . GLOSSARY. 



Ab-do'mex. The belly. 

A-ce-tab'u-lum. The socket for the head 
of the thigh bone; an ancient vessel for hold- 
ing vineirar. 

Ab-dom^i-xal cav'i-ty. The cavity of 
the belly. 

Ad-duc'tor. a muscle which draws one 
part of the body towards another. 

Ab-sor''bexts. Glands and vessels which 
absorb or suck up substances from within, 
or Avithout; also, medicines which, thouj^h 
nearly or quite inactive themselves, absorb, 
or combine with acid matter in the stomach 
or bowels. 

A-crc'mi-on. That part of the scapula, or 
shoulder-blade, which unites with the collar- 
bone. 

Al-bu-gin'e-a. The white of the eye. 

Al'ter-a-tives. Medicines which' jijadu- 
ually reestablish health, without sensibly in- 
creasing? the circulation, or augmenting the 
perspiration, urine, or other excretions. 

Al-'ve-o-lar. Relating to the sockets of 
the teeth. 

Al'vixe (AVvin). Relating to the intes- 
tines, as alvine discharges, — discharges from 
the bowels. 

A-M0R''PH0us. Having no regular form. 

Am-xi-ot'ic Liq'uid. The fluid surround- 
ing the fetus in the womb. 

Ax-^s-the'sia. Suspended sensibility. 

Ax-as-'to-mose. The uniting of arteries 
and veins by joining their mouths. 

Ax-CHY-Lo'sis. A stiff or useless joint. 

Ax-i-MAL''cu-L,E. Animals so small that 
they can only be seen with a microscope. 

Ax-ce''mi-a. Privation of blood; a com- 
paratively bloodless state. 

Ax''o-DTXES. Medicines which diminish 
sensibility, abate pain, and induce sleep. It 
should always be remembered that anodynes 
when frequently, and long taken, lose their 
influence in disease. 

AxT-A''ciDS. Preparations which neutral- 
ize acidity of the stomach and bowels. 

Axt-al'ka-lies. Agents which neutralize 
alkalies. 

Ax-TA-PHRO-Dis'i-Acs. Agcnts which les- 
sen or blunt the sexual propensities. 

Ax-thel-mix''tics. Medicines which des- 
troy and expel worms. 

Ax''ti-dotes. Medicines which counteract 
and destroy the eff'ects of poison. 

Ax-ti-pe-ri-od''ics. Medicines which pre- 
vent or cure diseases of a periodical character. 

Ax-ti-phlo-gis''tics. Medicines or diet 
which remove or appease inflammation. 



An-ti-spas-mod''ics. Medicines which pre- 
vent or allay spasms, commonly called cramps. 

Ax-ti-syph-i-lit'ics. Medicines which 
cure syphilis. 

Ax-ti-sep''tic. Whatever checks or coun- 
teracts putrefaction. 

Ax-ti-scor-bu'tics. Articles which pre- 
vent and cure scurvy. 

A-pe'ri-exts. Medicines which gently 
open the bowels. 

A-PHO^xi-A. A loss of the voice. 

Aph-ro-dis'i-acs. Medicines supposed to 
excite and promote the sexual appetite. 

A-pox-EU-RO'sis. The membranous ex- 
pansion of tendons and muscles. 

A-re-c'la. a colored circle, as the circle 
around the nipple. 

Ar-o-mat''ics. Medicines which have a 
gi-ateful, spicy smell, and an agreeable, pun- 
gent taste. 

As-PHYx'i-A. Suspended animation ; ap- 
parent death. 

As-THEx''ic. Relating to debility; or to 
disease marked by debility. 

As-trin'gexts. Medicines which have the 
power to constringe or pucker up the tissues 
of the body, and thereby check discharges. 

At''ro-phy. a wasted condition; leanness. 

Ax-il''la. The arm-pit, 

Aus-cul-ta'tion. The art of detecting 
disease by listening to the sounds of the lungs, 
heart, etc. 

Au-TOp'sY. Personal inspection, — used in 
the sense of a post-mortem examination. 

A-zote'. Nitrogen; one of the constitu- 
ents of the atmosphere. 

Brox'chi-a. The pipes which convey the 
air through the lungs. 

Bur's^ Mu-co'sa. Small sacs, situated 
under tendons, about the joints, containing a 
sticky fluid. 

Cal'cu-lus. a solid, unorganized body 
formed in the kidneys, or bladder, and called 
a stone. The plural is calculi. 

Cap''il-la-ry. Small; resembling a hair. 

Cap'sule. a membraneous bag, enclos- 
ing a part. 

Car^'ti-lage. Gristle attached to the ends 
of the bones. 

Car-mix'a-tives. Medicines which expel/ 
wind from the stomach and bowels, and allay' 
the pain caused by it. 

C A-T H ar't I c s . Medicines which purge the 
bowels. 

Cer'vix. The neck. Cer^vix Wter-i. The 
neck of the womb. 

Car'di-ao. Relating to the heart. 



716 



GLOSSARY. 



Car'pal. Relating to the wrist. 

Cat-a-me'ni-a. The monthly flow of fe- 
males. 

Ca-thar'sis. Purfring. 

Cath'e-ter. a tube for drawing off the 
urine. 

Cel-lu'lar. Relating to cells. 

Cer'e-bkal. Relating to the brain. 

Cha-lyb'e-ate. Containing iron or steel. 

Che-mo'sis. a swelling of the eye, in 
which the eye projects, with a depression in 
the centre. 

Ciio'LA-GOGUE. A medicine which causes 
a discharge of bile. 

Clo'nic Spasms. Spasms which are rigid 
and relaxed alternately. 

CoL-Li'QUA-TivE. This term is applied to 
excessive and exhausting discharges. 

Co-los'trum. The first secretion of milk. 

Co'ma. Profound stupor, or sleep. 

Con'dyle (kon'dil). A knob; applied to 
certain projections of bones at joints. 

Cox'flu-ent. Not distinct; I'unning to- 
gether. 

Cox-gen'i-tal. Existing at the time of 
birth. 

Cox-ges'tiox. Distention of parts by an 
accumulation of blood in them. 

Cox-juxc'ti-va. The membrane which 
covers the eye and lines the eye-lid. 

Cox'tra-Lv'di-ca-ted. Not indicated; the 
opposite implied. 

Cord'ials. Medicines which have a grate- 
ful, warming, and exhilarating effect upon the 
stomach. 

Coun'ter-Ir'ri-tants. Articles which by 
iiTitating one part, withdraw blood from, and 
relieve another. 

Cri'sis. The turning point of a disease. 

Cu'ti-cle. The epidermis; the scarf-skin. 

De-cid'u-a. a thin, external membrane, 
within the womb, thrown off after child-bear- 
ing. 

De-liq'ui-um. Fainting. 

De-mul'cexts. Medicines of a softening 
nature, which correct acrid conditions, and, by 
their bland effects, soothe inflamed and irri- 
tated parts- 

De-ple'tion. Diminishing the fulness of 
a part or parts, as by purgatives, or bleeding. 

De-squa-ma'tiox. Separation of the skin 
in scales; scaling off. 

De-ter'gexts. Medicines which cleanse. 

Di-AG-xo'sis. The art of determining the 
nature of diseases. 

Di-a-pho-ret'ics. Medicines which pro- 
mote sweating. 

Di-ath'e-sis. Any particular disposition, 
state, or habit of body. 

Di-u-re'sis. Copious flow of urine. 

Dil'u-exts. Watery drinks, which increase 
the fluidity of the blood, and render several of 
the secretive and excretive fluids less viscid. 

Dis-cu'tiexts. Medicines which scatter, 
resolve, or disperse tumors. 

Dis-ix-FEC'TAXTS. Articles which purify 
or cleanse infected places. 

Di-u-ret'ics. Medicines which increase 
urinary secretions. 

Dras'tics. Strong and violent purgatives. 

Dysp-nce'a. Difficulty of breathing. 

E-me'sis. Vomiting. 

E-met'ics. Medicines which cause the 
stomach to reverse its action, and throw its 
contents up through the mouth. 



Em-3ien'a-gogues. Medicines supposed to 
have the power of exciting or increasing the 
menses. 

E-mol'lients. Those substances which 
have the power of softening or relaxing the 
animal flbre, when applied externally. 

Ex-dem'ic Dis-eas'es. Diseases prevail- 
ing in certain localities or districts. 

Ep-i-dem'ic Dis-eas'es. Diseases extend- 
ing over a large extent of country. 

Ep-i-glot'tis. The cartilage, which, in 
the act of sv\-allowing, shuts down upon the 
top of the wind-pipe, and prevents food from 
going into the breath-passage. 

Ep-is-pas'tics. Substances which inflame 
the skin, and raise the cuticle, and cause what 
is called a blister. 

Es-cha-rot'ics. Articles which bum, cor- 
rode, disorganize, and destroy the animal tis- 
sues, causing what is called an eschar, or 
slough, which is dead matter, and falls off. 

Ex-pec'to-raxts. Articles which act upon 
the system, so as to make the discharge of 
mucus and other substances from the air-tubes 
more easy. 

Er'rhixes. Substances which cause sneez- 
ing, and a discharge of mucus from the nose 
when snuffed. 

Es'cHAR. The dead part, killed by caustic, 
or mortification, which falls off; a slough. 

Ex-fo-li-a'tiox. a scaling off, as a piece 
of dead bone. 

Fau'ces. The back part of the mouth. 

Fe'brile. Belonging to fever. 

Fe'ces. The matter discharged from the 
bowels. 

Feb'ri-fu-ges. Medicines which assuage 
or remove fevers. 

Fla'tus. Wind, or rather, gas, in the stom- 
ach or bowels. 

Fol'li-cle. a little bag or sac. 

Fo-ra'mex. a hole, or opening. 

For-mi-ca'tiox. a sensation like the creep- 
ing of ants. 

Fur-fu-ra'ceous. Branny, or scaly. 

Gaxg'li-on. An enlargement in the course 
of a nerve. 

Gax'grexe. Mortification; partial death. 

Gas'tric. Belonging to the stomach. 

Ges-ta'tiox. The period of pregnancy. 

Glot'tis. The opening into the wind-pipe, 
covered by the epiglottis. 

Gran'u-lar. Like small grains. 

Gran'u-la-ted. Covered with granula- 
tions. 

Gran-tj-la'tiok". The filling up or cover- 
ing of a wound, or ulcer, with small, red eleva- 
tions, looking like grains. 

H.e-mop'ty-sis. Raising blood from the 
lungs. 

He-mi-cra'ni-a. Pain on one side of the 
head. 

H.^cm'or-rhage. a flow of blood. 

H.em-or-rha'gic Having a tendency to 
bleed. 

He-pat'ic. Belonging to the liver. 

Hy-per-ca-thar'sis. Excessive purging. 

Hy-per'tro-phy. An unnatural enlarge- 
ment of an organ, without change of structure. 

Hyp-xot'ics. Medicines which cause sleep. 

Ich'or (Ik'or). A thin, watery, and acrid 
discharge. 

Ix-ter-cos'tal. Between the ribs. 

Lar'yxx. The top of the wind-pipe; the 
cavity which contains the vocal ligaments. 



GLOSSARY. 



717 



Lax'a-tives. Medicines whieh render the 
bowels a little more relaxed than natural, but 
do not purge. 

Lig'ateT To secure with a lif^ature. 

Lig'a-ture. a cord, or thread. 

Lo'CHi-A. The bloody discharije from the 
womb for some time after child-birth. 

Lo'cHi-AL. Rolatinir to the lochia. 

Lymph. A whitish fluid contained by the 
lymphatic vessels. 

" Lym-phat'ics. The vessels which carry 
lynlph. 

' Mac-er-a'tiox. The act of softeninj? or 
soakini: a thinii; by letting; it stand in water. 

Mac'u-l.e. Colored spots; blemishes. 

Ma-la'ri-a. Noxious gases from decom- 
posed matter. 

Ma.ai'.ma. The female breast. 

MAX-Din'u-LAR. Relating to the jaw. 

Mas-ti-ca'tiox. The act of chewing. 

Mas-tur-ba'tiox. The act of exciting the 
genital organs with the hands. 

Men'stru-um, Any solvent, or vehicle. 

]\Iet-a-car'pus. The hand between the 
wrist and the tingers. 

Me-tas'ta-sis". The changing of a disease 
from one place to another. 

Met-a-tar'sus. That part of the foot be- 
tween the ankle and the toes. 

Mi-AS-.MAT'ic. Partaking of the nature of 
miasm. 

Ml''co-pc'ri-form. Composed of both 
mucus and pus. 

Mu'co-se'ro-lext. Composed of both 
mucus and serum. 

!Nar-cot'ics. Medicines which relieve pain 
and produce sleep. 

Xau'se-axts. Medicines which cause sick- 
ness at the stomach, or a disposition to vomit. 
They are often used as expectorants. 

N'os-ol'o-gist (Nose-ol'o-gist). One who 
explains and classifies diseases. 

Xu'cLE-us. A central spot. 

Is u-CLE-o'Lus. A spot within a nucleus. 

Or-thop-xce'a. Great dithculty of breathing, 

Os U'TER-i. The mouth of the womb. 

Os-si-fi-ca'tiox. The formation of bone. 

O'vuM. An e'^g. O'va. Eggs. 

Pa-pi l'la. A red, elevated point upon the 
tongue, or elsewhere. Certain diseases make 
these points more prominent. 

Par-a-cex-te'sis. The operation of punc- 
turing the chest, or the abdomen, for the pur- 
pose of drawing off water. 

Par-a-phle'gi-a. Paralysis of the lower 
half of the body. 

Par'ox-ts3i. a fit of disease taking place 
periodically. 

Par-tu'ri-ext. Bringing forth, or giving 
birth. 

Par-tu'ri-exts. Medicines which promote 
child-bed labor, by causing contractions of the 
womb. 

Par-tu-ri'tiox. Child-birth. 

Pec'to-rals. Medicines intended to cure 
or relieve diseases of the chest. 

Pel'vis. The bony cavity, or basin, at the 
lower part of the body, containing the womb, 
abdomen, rectum, etc. 

Per-i-xe'um. The part, or space, between 
the anus and testicles. 

Per-1-os'te-um. a thin, hard membrane, 
covering the bones, 

Per-1-os-ti'tis. Inflammation of the peri- 
osteum. 



Per-i-to-xe'um. a serous membrane lin- 
ing the cavity of the belly, and folded over 
most of the organs contained in it. 

Pet-e'chi-^. Purple spots which appear 
upon the skin in low fevers, looking like flea- 
bites; called also ecchymoscs. 

Pha-ge-i)Ex'ic. Corroding, eating, — ap- 
plied to ulcers, 

Pha-lax'ges. The bones of the fingers and 
toes. 

Phar'yxx. The upper part of the throat. 

PiiLEG-MO'NOus Ix-flam-ma'tion. Inflam- 
mation marked by redness, heat, and pain, 
and a tendency to form matter. 

Prog-xo'sis. The art of foretelling the 
termination of diseases. 

Pty'a-lism. Salivation. 

Pri'a-pism. a continued erection of the 
penis from exciting, morbid causes. 

Re-frig'er-axts. Medicines which lessen 
the heat of the body. 

Re-lax'axts. Medicines which relax the 
tension of the muscles. 

Re-mis'siox. a lessening or mitigation of 
the severity of the symptoms of a disease. 

Res-o-lu'tiox. Dispersion of an inflam- 
mation before pus is formed. 

Rii-vuL'siVES. Medicines or appliances 
which remove a disease by causing a deter- 
mination to some other part. 

Ru-he-fa'ciexts. Applications which ex- 
cite the skin, causing the blood to flow to it, 
and making it red. 

Sa'xies. a thin fluid discharged from ul- 
cers, having some of the properties of pus and 
blood. 

Sed'a-tives, Medicines which diminish 
the action of the heart and nerves, and which 
are used when we wish to allay any excited 
action in the system. 

Se'rous, Watery. 

ScRO'TUM. The bag which contains the 
testicles, 

Scyb'a-la. Hard, round lumps in the feces. 

Si'a-la-gogues. Medicines which increase 
the flow of saliva. 

Slough {Sluff) Any part of the body 
killed by mortification, or caustic, and cast off. 

Sper-mat'ic Cords, Two cords, composed 
of nerves, veins, and arteries, descending, one 
on each side, from the abdomen into the scro- 
tum, and suspending the testicles. 

Squa'mous. Scaly; having scales, 

Sor'des, The dark matter deposited upon 
the lips and teeth, in low fevers. 

Ster'xum. The breast-bone, 

Ster'tor. Noisy breathing, as in apo- 
plexy. Snoring. 

Ster'tor-ous. Snoring and noisy, as ap- 
plied to breathing. 

Stim'u-laxts. Medicines which increase 
the activity of the system. 

Sto-mach'ics. Medicines which support 
and renovate the stomach, making its action 
healthy. 

Stru'ma. Scrofula. 

Styp'tics. Substances which, when ap- 
plied externally, have the power to constringe 
or pucker up bleeding vessels, and stop the 
loss of blood. 

Sub-cu-ta'ne-ous, Under the skin, 

Sub-max'il-la-ry, Under the lower jaw. 

SuB-suL'Tus Ten'di-xum. Slight twitch- 
ings of the tendons, which occur in low forms 
of fever. 



718 



GLOSSARY. 



Su-do-rif'ics. Medicines which cause a 
flow of perspiration, rather more free than 
that produced by diaphoretics. 

Sup-POs'i-TO-RiES. Solid medicinal sub- 
stances, of a conical or cylindrical shape, 
which are placed in the rectum for the pur- 
pose of relieving constipation and the piles, 
and for removing stricture. 

Syn'co-pe. Fainting; swooning. 

Te-nes'mus. a painful bearing down in 
the lower bowel, and a distressing desire to go 
to stool. 

Ton'ics. Medicines which gradually give 
tone and strength to weakened organs, or to 
the whole system. Some act upon the ner- 
vous sj'stem, and some upon the other tissues, 
by condensing, hardening, and invigorating 
them. 



Tor'mi-n A. Griping pain. 

U-re'ters. The tubes which convey the 
urine from the kidneys to the bladder. 

U-re'thra. The canal which conveys the 
urine from the bladder out of the body. 

U'ter-us. The womb. 

Vag'i-na {VadgH-na). The passage from 
the external genital organs to the womb. 

Va'ri-cose Veins. Veins which are mor- 
bidly enlarged, and present along their course 
soft, knotty, purplish tumors. 

Ver'ti-go. Dizziness ; giddiness. 

Ve-si-ca'tion. Blistering. 

Vi'rus. Poison; contagion. 

Vis'cus. A liver, stomach, kidney, heart, 
or any organ within one of the cavities of the 
body. 



It is believed that the hard words introduced into this book, and not contained in 
the above Glossary, are nearly or quite all explained at the places where they are 
used. 



IIN-DEX 



Abdominal Cavity, Diseases 

ot, 260 

Abies Canadensis, 615 

- Excelsa, 600 

" Picea, atO 

Abortion, 378 

Abscesses, . 427 

Absence of Menses, 352 

Absorbent Vessels, 38 

Acacia Catechu, 602 

Accidents on Water, 494 

" bv Toisoning, 494 

Acetate of Copper, poisoning 

bv, 495 

" " Lead, poisoning by, 496 

" " '• Ointment, 673 

Acetum, 658 

Achillea Millefolium, 662 

Acid, Acetic, 588 

" Citric, 588 

" Diluted Hydrochloric, 589 

" " Hydrocyanic, 589 

" " Kitric, 588 

" " Sulphuric, 589 

" Nitre Muriatic, 589 

" Tannic, 589 

•' Tartaric, 589 

Aconite, 630 

" Poisoning by, 497 

" Tinct. of, 686 

Aconitum Napellus, 661 

Acorus Calamus, 656 

Adipous Sarcoma, 469 

Affections of Chest, 572 

" Head, 672 

" " Stomach and 

Bowels, 574 

Affusion, The, 536 

Age, Influence of, 121 

Ague Root, 653 

'' Fever and, 411 

Air Cells or Vesicles, 35 

" " Enlargement of, 234 

" in Chest, 236 

" Swellings, 281 

" and Ventilation, 108 

Albiimen, 15 

Albuminuria, 297 

Alcohol, 689 

Alder, Tag, 656 

Aletris Farinosa, 653 

Aliments. Fluid, 566 

Allium Cepa, 634 

Sativum, 613 

Almonds, 589 

Sjrup of, 682 

Almond Mixture, 672 

Alnus Rubra, 656 

Aloes, 590 

" Comp. Tinct. of, 688 

" and Canella, Compound 

Powder of, 680 

Alpinia Cardamomum, 602 

Althaea Officinalis, 629 

Alum, 590 



PAOB 

Alumen, 590 

Amaurosis, 484 

Amenorrhoea, 352 

American Hellebore, 590 

" Ipecacuanha, 591 

" Ivv, 591 

" Valerian, 663 

Ammonia, Aromatic Spirit of, 592 

'• Carbonate of, 591 

" Muriate of, 591 

" Poisoning by, 494 

" Solution of Acetate 

of, 592 

" Water of, 691 

Ampelopsis Quinquefolia, 591 

Amusements, 114 

" Games for, 114 

" Lighter, 115 

" Want of, 116 

Amygdalus Communis, 689 

Persica, 636 

Anagallis Arvensis, 645 

Anasarca, 816 

Anatomy, 14 

" of Bones, 18 

Anchylosis, 464 

Aneurisms, 470 

Aneurismal Tumors of Heart, 250 

Angina Pectoris, 258 

Anise, 592 

Ankle, Dislocation of, 461 

Anthemis Nobilis, 604 

Anthrax, 432 

Antidotes of Poisons, 494 

Antimony, Poisoning by, 495 

Antipathies, 658 

Aorta, 37 

Apocynin, 595 

Apocynum Androsaemifolium, 595 

Apoplexy, 160 

Apparent Death from Various 

Causes, 492 

Apple Water, 679 

Apthae, 397 

Aqua Calcis, 626 

Arachnitis, 153 

Arachnoid, 45 

" Inflammation of, 153 

Aralia Hispida, 611 

" Racemosa, 650 

" Spinosa, 643 

Arbutus, Trailing, 656 

Argenti Nitras, 632 

Anstolochia Serpentaria, 658 

Arnica, 592 

" Montana, 592 

Aromatic Powder, 680 

Spirit of Ammonia, 592 

Arrow Root, 692 

" " Gruel, 679 

Arsenic, 495 

Arsenical Solution, 651 

Artemisia Absinthium, 662 

Arteries, 36 

'' Pulmonary, 37 



Asarum Canadense, 


660 


Asclepias Incarnata, 


655 


" Syriaca, 


607 


" Tuberosa, 


639 


Ascites, 


315 


Asiatic Cholera, 
Aspidum Filix Mas, 


288 


628 


Assafoctida, 


592 


" Comp. Tinct. of. 


688 


Atmosphere, Pressure of, 


108 


Atropa Belladonna, 


610 


Atrophy, 


251 


Attendants, Unhired, 


557 


Aurantii Cortex, 


635 


Auricles, 


36 


Auscultation, 


210 


Balm, 


592 


'' ofGilead, 


593 


Balmony, 


593 


Balsam Copiava, 

" ToTu. 
Balsamodendron Myrrha, 


693 


693 
632 


Bandages, Wet, 


547 


Baptisia Tinctoria, 


660 


Barberry, 
Barbers' Itch, 


693 


149 


Barley, 


77 


" Coffee, 


577 


Barosma Crenata, 


699 


Barrenness, 


269 


Basilicon Ointment, 


665 


Bath, Cataract, 


632 


" Cold Foot, 


537 


" Douche, 


531 


*' Eye and Ear, 
" Half, 
« Head, 


538 


633 


534 


'« Hose, 


632 


" I>eg, 


534 


" Mouth or Oral, 


539 


" Nose, 


538 


'^ Plunge, 


634 


" Shower, 


532 


" Sitz, 


535 


" Towel and Sponge, 


536 


" Wading Foot, 


538 


" Warm Foot, 


538 


" Wash-Tub, 


535 


" Wave or Sluice, 


633 


" Cold, 


640 


" " Effects of, 


641 


♦' Hot, 


640 


" " Effects of, 


542 


" Tepid, 


540 


" " Effects of. 


541 


» Vapor, 


540 


" Warm, 


540 


♦' " Effects of, 


542 


Baths of the Ancients, 


103 


" Cold, 


105 


" Division of. 


539 


" Names of. 


104 



Neglect of, 
Reaction after. 



104 

107 



1 


720 


INDEX. 








PAGE! 


PAGE 




PAGE 


Baths, Shower, 


106 Brain, Dropsy of, 


158 


Cartilage, Ar5"tenoid, 


41 


" Spouge, 


105 


" Enlargement of, 


156 


" Crycoid, 


41 


" Vapor, 


106 


" Exercise of, 


58 


" Thyroid, 


41 


" Warm, 


106 


" Fever, 
" Health of, 


153 


Caryophillus Aromaticus, 


605 


Bathing and Cleanliness, 


101 


57 


Cascarilla, 


602 


" Sea, 


642 


" Induration of, 


155 


Caseine, 


16 


Bayberry, 


594 


" Inflammation of. 


153 


Cases Treated, 


203 


" Ointment, 


674 


" and Nerves, diseases of, 152 


Cassia Acutifolia, 


648 


Bean, St. Ignatius's, 


654 


" Old People's, 


59 


" Buds, 


605 


Beans, 


70-78 


" Overworking, 


59 


Castor, 


602 


Bearberry, 


593 


" Shrinking of. 


157 


" Oil, 


602 


Beds and Bedding, 


96-551 


" Softening of, 


154 


Castoreum, 


602 


Beef Tea, 


580 


" Tumors of. 


155 


Catalepsy, 


168 


" Essence of, 


580 


Bran, Decoction of. 


576 


Cataplasms, 


678 


Beets, 


79 


Brandy Mixture, 


672 


Cataract Bath, 


632 


Beeves' Galls, 


594 


Bread and Water Poultice, 


678 


Catarrh, 


189 


Belladonna Atropa, 


610 


Breast Bone, Fracture of, 


450 


Catarrhal Opthalmia, 


482 


" Ointment, 


674 


" Broken, 


386 


Catechu, 


602 


«' Plaster, 


677 


" Inflammation of. 


386 


" Tinct. of, 


687 


" Poisoning by, 


497 


Breathing, Objects of, 


108 


" Comp. Tinct. of. 


&S8 


Benzoic Acid, 


594 


Philosophy of. 


108 


" Comp. Powder of. 


680 


Benzoin, 


594 


Bright's Disease of Kidneys, 
Broken Bones. 


297 


Catnip, 


602 


Comp. Tinct. of, 


688 


444 


Caulophyllum Thalictroides, 


597 ' 


Berberis Vulgaris, 


593 


Bronchial Tubes, 


35 


Caulophyllin, 


598 


Bethroot, 


595 


" Consumption, 


217 


Cayenne Pepper, 

" Tinct. of, 


603 


Bile in Stomach, 


64 


Bronchitis, Acute, 


231 


687 


Biliary Calculi, 


266 


" Chronic, 


233 


Ceanothus Americanus, 


645 


Bilious Colic, 


282 


Bronchocele, 


471 


Celandyne, 


603 


'• Remittent Fever, 


409 


Bruises, 


462 


Cerates, 


664 


Bismuth, 


595 


Bubo, 819 


-327 


Cerebellum, 


44 


Nitrate of. 


695 


Buchu, 


599 


Cerebrum, 


44 


" Subnitrate of, 


695 


" Tinct of. 


687 


Cerevisiae Fermentum, 


662 


" Trisnitrate of, 


595 


Buckhorn Brake, 


599 


Cessation of Menses, 


360 


" White Oxide of, 


595 


Buckthorn, 


599 


Cetaceum, 


652 


Bitter Root, 


595 


Buckwheat, 


79 


Cetraria Islandica, 


619 


Bittersweet, 


595 


Bugleweed, 


600 


Chafing, 


490 


Black Alder, 
" Cohosh, 


596 


Bunions, 


465 


Chalk, 


603 


596 


Burdock. 


600 


" Mixture, 


672 


" " Comp. Tinct 


of, 689 


Burgundy Pitch, 


600 


" Comp. Powder of. 


689 


" Root, 


607 


Burns, 


433 


" Comp. Powder of, with 1 1 


«' Willow, 


597 


Butternut. 


600 


Opmm, 


680 


Blackberry, 


596 






Chamomile, 


604 


Bladder, 


34 


Cabbage. 


79 


Charcoal, 


604 


" Acute Inflammation of, 295 


Skunk, 


649 


Chelidonium Majus, 


603 


" Chronic " 


" 296 


Calamine Cerate, 


664 


Cheloue Glabra, 


593 


Bleeding from Kidneys, 


300 


" Prepared, 


664 


Chemical Food, 


684 


" " Nose, 


489 


Calamina Praeparata, 


664 


'* Injuries, 


433 


» " Wounds, 


491 


Calcined Deer's Horn, 


600 


Chenopodium Anthelminti 




Blenorrhagia, 
Blistering Plaster, 


329 


Calculus. 


313 


cum. 


662 


665 


Calf's Feet Jelly, 


581 


Cherry, Wild, 


659 


Blood in Scrotum, 


472 


Calico Bush, 


631 


Chest, Affections of, 


572 


Bloodroot, 


597 


Calomel, 


600 


" Air in, 


236 


Bloody Jlux, 
Blue Cohosh, 


290 


Calx, 


626 


" Diseases of, 


209 


597 


" Chlorinata, 


626 


" Water in, 


237 


" Comp. Tinct 


of, 689 


Camphor, 


601 


Chicken Water, 


681 


" Disease, 


406 


" Liniment, 


669 


Chickweed, Red, 


645 


" Flag, 


598 


" Water, 


671 


Chilblains, 


466 


" Pill, 


598 


Camphorated Soap Linimeni 


,670 


Ciiild-bed Fever, 


385 


Body, Structure of the, 


14 


Canabis Indica, Tinct. of, 


687 


Children, Care and Diseases 1 1 


" Chemical Properties 


of, 14 


Canada Balsam, 


601 


of, 


389 


'' Physical 


" 16 


" Fleabane, 


601 


" Nursing Sick, 


392 


" Vital, " 


" 18 


" Snake Root, 


660 


" Weaning of, 


390 


Boiled Flour, 


580 


Cancer, 


467 


Chimaphila Umbeliata, 


639 


Boils, 


431 


" of Mouth, 


398 


Chloroform. 


604 


Bones, Anatomy of, 


18 


Cancrum Oris, 


398 


Chloroformum, 


604 


1 " Diseases of. 


463 


Canella, 


601 


Chlorosis, 


358 


« Death of, 


463 


" Alba, 


601 


Choice of Sick Room, 


549 


" of Head, 


20 


Canker Lettuce, 


646 


Cholera, Asiatic, 


28S 


" " Trunk 


21 


Cantharis Versicatoria 


652 


" Infantum, 


402 


" " Upper Extremit 


ies, 22 


Cantharides, Tinct. of. 


687 


" Morbus, 


2S8 


« " Lower " 


24 


Capillaries, 


37 


Chorea, 


169 


" Time required for unit- 


Capsicum Annuum, 


603 


" Chronic, 


170 


ing, 


445 


" Plaster, Comp., 


677 


Choroid Coat, 


49 


" Unnatural Growth of, 463 


Caput Obstipum, 


478 


Chyle, 


64 


" Ulceration of. 


463 


Caraway, 


601 


Chyme, 


64 


» Uses of, 


26 


Carbo Ligni, 


604 


Ciliary Processes, 


49 


Boneset, 


598 


Carbuncle, 


432 


Cimicifuga Racemosa, 


596 


Borax, 


650 


Cardialgia, 


274 


Cimicifugin, 


597 


1 Bowel, Falling of. 


403 


Cardamom, 


602 


Cinchona, 


637 


1 Bowels, Affections of. 


575 


Comp. Tinct. of, 


688 


Cinchonia, 


637 


1 " Acute Inflammation of, 279 


Carditis, 


253 


Cinnamon, 


605 1 


" Chronic 


" 280 


Care of Children, 


389 


" Tinct. of, 


687 


" Looseness of, 287-401 


" " Teeth, 


489 


" Comp. Tinct. of. 


688 


Brachial Plexus, 


47 


Caries, 463—489 


Circulation, Organs of. 


36 


Brain, 


44 


Carrots, 


79 


Cirsocele, 


476 


" Abscess of, 


155 


Carum Carui, 


601 


Citric Acid, Syrup df, 


632 





INDEX. 


721 


1 


PAOEl 


PAGE, 


PAGE 


i Citnis Limonum, 


625 


Corn, Indian, 


78 


Dislocations of Hip Joint, 


459 


j Clap, 


329 


Cornea, 


49 


" "• Knee J'an or || 


1 Cleauino: the Teeth, 


m 


'' Inflammation of, 


483 


Patella, 


461 


Clean liiiess, 100 


,563 


Corneitis, 


483 


*' " Knee Joint, 


461 


Cleavers, 


605 


Corns, 


145 


*' " Lower Jaw, 


456 


Clergymen's Sore Throat, 


191 


Cornu Cervina; Ustum, 


600 


" " Shoulder 




Clinuite. 


71 


Cornus Florida, 


611 


Joint, 


457 


Clothes Catching Fire, 


494 


" Servicea, 


655 


" " Wrist, 


458 


Clothing 


98 


Corrosive Sublimate, 


607 


Disturbed Sleep, 


182 


" Color of, 


100 


" '' Poisoning by 


,495 


Dizziness, 
Dock, Yellow, 


181 


" Cotton, 


99 


Corydalis Formosa, 


657 


662 


" Hair as, 


99 


Costiveness, 


284 


Dogwood, 


610 


" Linen, 


98 


Cotton, 


608 


" Poisoning by, 


497 


" I'orous, 


100 


Coup de Soliel, 


162 


" Swamp, 


655 


" Silk, 


99 


Cow Pox, 


136 


Domestic Management of the 1 1 


» Tisiht, 101 


,111 


Coxalgia, 


464 


Sick-Koom, 


549 


" Woollen, 


99 


Cramp Bark, 


617 


Doses, 


586 


Clover, Ked, 


645 


Cramps, 


171 


Douche Bath, 


531 


Cloves, 


605 


Cranesbill, 


608 


I'ail, 


532 


Clovus, 


145 


Cranial Nerves, 


45 


Dover's Powder, 


680 


Clysters, 


669 


Crawley, 


608 


Dragon Koot, 


619 


Coccus Cacti, 


605 


Cream of Tartar, 


641 


Dress, Wet, 


528 


X-occulus I'almatus, 
Tocliiiieal. 


606 


Creosote, 


609 


Drink, Pleasant, 


577 


605 


Ointment, 


674 


Dropsy of Belly, 


315 


Cochlearia Armoracia, 


618 


Creosotum, 


609 


- - Cells, 


316 


Cod Liver Oil, 


605 


Crocus Sativis, 


646 


" General, 


316 


Cotfee, 


84 


Croton Eleuteria, 


602 


Dry Pimples, 


144 


'• Barley, 


577 


" Oil, 


609 


Drunkard's Delirium, 


155 


" Crust, 


677 


" " Liniment, 


670 


Dura 3Iater, 


45 


" Milk, 


583 


" Tiglium, 


609 


" " Inflammation of 


, 1-2 


Colchicum Autumnale, 


630 


Croup, 


399 


Dwarf Elder, 


611 


Comp. Tinct. of. 


689 


Crow Corn, 


653 


Dysentery, 


290 


Cold, Effects of. 


434 


Crural Phlebitis, 


385 


Chronic, 


291 


" Foot Bath, 


537 


Crust Coffee, 


577 


Dysmenorrhoea, 


355 


Colds, 


205 


Crusted Tetter, 


142 


Dyspepsia, 


L69 


Colic, 


403 


CubebiB, 


609 


" Causes of. 


270 


" Bilious, 


282- 


-^ubebs,. 


609 


" Treatment of, 


272 


*' I'ainter's, 


283 


Cucumber, Wild, 


660 


" Urinary Deposits in 


, 2;o 


" Wind, 


280 


Cucumis Colocyuthis, 


606 


Dyspeptics, 


81 


Colica rictonum, 


283 


Culver's Root, 


609 






Colitis, 


290 


Cupri Subacetas, 


607 


Ear, Affections of. 


486 


Colocynth, 


606 


Cupri Sulphas, 


607 


" Drum of, 


51 


Colodion, 


606 


Cuprum, 


607 


" External, 


51 


Colombo, 


606 


Cyanosis, 


406 


" Foreign Substances in. 


490 


Colon. 


32 


Cypripedin, 


663 


" Wax in, 


488 


Coltsli.ot, 


606 


Cvpripedium Pubescens, ^62^ 


,663 


Earache, 


488 


Coifs Foot, 


660 


Cystine Deposits in Urine, 


312 


Eclectics, 


7 


Comtrey, 


606 


Cystirrhcea, 


296 


Ecstasy, 


168 


'• Comp. Wine of, 


671 


Cystitis, 


295 


Ecthyma, 


142 


1 Common Silk Weed, 


607 






Eczema, 


139 


Complonia Aspleuifolia, 


655 


Dancing, 


92 


Effervescing Draught, 


642 


Comp. Fractures, 444 — 453 


Dandelion, 


610 


Egyptian Ophthalmia, 


480 


" Infusion of Catechu, 


668 


Datura Stramonium, 


654 


Elbow, Fractures of. 


448 


" '' " Gentian, 


668 


Deadly Nightshade, 


610 


'' Joint, Dislocation of, 458 1 


" " " Geranium 


,668 


Deafness, 


488 


Elder, 


611 


" " «' Parsley, 


668 


Death of Bones, 


463 


" Dwarf, 


611 


" " *' Senna, 


668 


Decoction of Bran, 


576 


Elecampane, 


611 


Comp. Infusion of Trailing 


Decoctions, 


666 


Electro Magnetism, 


611 


Arbutus, 


669 


Deformities of Spine, 


476 


Electuaries,^ 


666 


Compresses, 


547 


Dehsler's Cerate, 


665 


Electuary, Lenitive, 


666 


ConfL-ctions, 


666 


Delivery, 


379 


Elixir Salutis, 


691 


" Aromatic, 


666 


Delirium Tremens, 


155 


" Vitriol, 


687 


*' of Catechu, Comp. 


,663 


Dementia, 


175 


Elm, Slippery, 


650 


'> of Senna, 


66G 


Dens Leonis, 


610 


Emphysema, 


234 


Congestive Fever, 


410 


Derbyshire Neck, 


471 


Encephalitis, 


1^3 


'- — Coumm Maculatum, 


639 


Diabetes, 


299 


Encephaloid Tumor, 


468 


" Poisoning by, 


497 


Diarrhoea, 287 


-401 


Encysted. " 


469 


Conserves, 


666 


" Chronic, 


287 


Endocarditis, 


253 


Constipation, 


284 


Dictionary, 


715 


Enlarged Veins, 


473 


Constitution. 


120 


Diet, 22S 


,562 


Enonymus Atropurpureus, 


659 


" Idiosyncrasy of, 121 


" in Disease and Convales 




Enteritis, 


279 


Constitutional Differences, 


217 


cence, 


' 562 


Eneuresis, 


31.3 


Consumption, 


209 


Difficult Teeth Cutting, 


399 


Epigaea Repens, 


656 


" A General Disease 


,220 


Digestion, 


61 


Epiglottis, 


41 


" Bronchial, 


217 


Table, 


69 


" Inflammation of, 


207 


" Causes of, 215—218 


Digestive Organs, 


31 


Epilepsy, 


167 


" Tubercular, 


212 


Digitalis Purpurea, 


612 


Epileptic Fits, 


167 


Contused Wounds, 


439 


Dioscorea Villosa, 


660 


Epistaxis, 


489 


Contusions, 


462 


Diospyros Virginiana, 


637 


Ergot, 

Engeron Canadense, 


653 


Convolvulus Scammonia, 


648 


Diseases, General, 
" of Children, 


668 


eoi 


Cookery for Sick-Koom, 


576 


389 


Irruptions, Scaly, 


143 


Copiafera Officinalis, 


693 


Dislocations, 


455 


Erysipelas, 


136 


Copper, 


607 


of Ankle Joint, 


461 


Erythema, 


188 


" Subacetate of, 


607 


" " Bones of Head 


,459 


Erythematic Stomatitis, 


S96 


" Sulphate of. 


607 


" " Collar Bone, 


457 


Essences, 


667 


Corallorhiza Odontorhiza, 


608 


" " Elbow Joint, 
91 


458 


Essence of Beef, 


580 



722 


INDEX. 








PAGE 




PAGE 1 


PAGE 


Eupatorin, 


599 


Flaxseed, 


612 Gelseminin, 


663 


Eupatorium rerfolintum, 


598 


Flies, Spanish, 
Flour, Boiled, 


652 Gelseminum Sempervirens, 


662 


" Turpureum, 


644 


680 Gengivitis, 


398 


Euphorbia Ipecac, 


591 


Fluid Aliments, 


666 General Diseases, 


568 


Eupurpurin, 
Eustachian Tube, 


644 


" Extracts, 


667 


" System, Diseases of. 


407 


51 


" Nutritive, 


583 


Gentian, 


613 


Excoriation, 


490 


Fluor Albus, 


351 


" Comp. Tinct. of. 


689 


Exercise, 


88 


Folded Wet Sheet, 


529 


Gentiana Lutea, 


613 


" Active and Passive, 


89—93 


Follicles, 


40 


Geranium Maculatum, 


608 


" Excessive, 


89 


Follicular Inflammation of 




Gill-over-the-ground, 


615 


" In-door, 


93 


Mouth, 


397 


Ginger, 


613 


'• Mental Cooperation 


in, 94 


Fomentations, 


667 


" Wild, 


660 


" Out-door, 93—229 


Food, 


61 


" Syrup of, 


682 


" rieasurable. 


89-94 


" Albuminous, 


74 


Ginseng, 


614 


" Regular, 


89 


♦' Amount of. 


80 


Glands, 


40 


" for Students, 


90 


" Animal and Vegetable, 


81 


" Lachrymal, 


60 


" When to Take, 


89-95 


" Articles of, 


76 


" Oil, 


43 


" for Young Women 


91 


" Azotized and Non-azo- 




" Parotid, 


31 


Exhalants, 


40 


tized. 


67 


" Submaxillary, 


31 


Exostosis, 


463 


« Choice of. 


70 


» Sweat, 


43 


Extracts, 


667 


«' (^ost of. 


74 


Glauber's Salts, 


651 


" Fluid, 


667 


" Digestibility of, 


68 


Gleet, 


331 


Extract of Khubarb and Po- 


" Fatty, 


75 


Glossary, 


715 


tassa, 


672 


" Heat-generating, 


68 


Glottis, Spasm of. 


400 


Eyebrows, 


50 


" Nature and Destination 




Glycerin, 


614 


Eyelashes,' Disorder of. 


480 


of. 


65 


Glycerrhiza Glabra, 


626 


Eyelids, 


50 


" Nutritive, 


68 


Goitre, 


471 


" Inflammation of, 


479 


" in Old Age, 


73 


Gold, 


614 


Eye, Coats of. 


48 


" Organic, 


66 


Golden Seal, 


614 


" and Ear Bath, 


538 


" Starch and Sugar as, 


75 


" " Comp. Powder of, 680 i I 


" Foreign Bodies in. 


478 


" Tables of Value of, 


76 


♦' « " Tinct. of. 


689 


" Globe of, 


48 


" in Youth and Manhood 


73 


" « " Wine of, 


671 


" Humors of, 


49 


Foot Bath, Cold, 


537 


Golden Tincture, 


689 






'• " Warm, 


53S 


Gonorrhoea, 


329 


Faba Sancti Ignatii, 


654 


" Fractures of. 


453 


Gossypium Herbaceum, 


608 


Fainting, 


181 


Fore Arm, Fractures of. 


448 


Gout, 


415 


Falling of Bowel, 


403 


Foreign Bodies in Eye, 


478 


Granulation, 


440 


" " Womb, 


366 


Fowler's Solution, 


651 


Grass, Star, 


653 


" Over of Womb, 


366 


Foxglove, 


612 


Gravel, 


304 


False Grape, 


691 


Fractures, 


440 


" Root, 


644 


" Joints, 


445 


'' Compound, 

" of Bones of Foot, 


453 


" Uric Acid, 


306 


" Measles, 


138 


453 


Green Sickness, 


358 


" Sarsaparilla, 


650 


" " " '•' Nose, 


445 


Griflith's Myrrh Mixture, 


672 


" Unicorn, 


616 


'' Breast Bone, 


450 


Ground Ivy, 


615 


Fat, 


15 


" " Collar Bone or 


" Rice Milk, 


580 


Fatty Tumor, 


469 


Clavicle, 


446 


Grubs or Worms, 


148 


Favus, 


151 


'• " Elbow, 


448 


Gruel, Arrow Root, 


579 


Fel Bovinum, 


594 


" *' Fore Arm, 


448 


" Rice, 


578 


Felon, 


465 


" " Hand and Fin- 


" Sago, 


679 


Female Diseases, 


837 


gers, 


449 


" Water, 


578 


Fern, 


655 


'• " Haunch Bones or 


Guaiac, Ammoniated Tinct 




Ferri Ammonio Citras, 


621 


Pelvis, 


450 


of, 


■ 689 


" Citras, 


621 


« « Knee Pan, 


452 


Guaiacum, 


615 


'• lodidum, 


621 


" " Leg, 


453 


Gullet, Foreign Bodies in. 


491 


" Lactas, 


621 


" " Lower Jaw. 


446 


Gum Arabic, 


615 


" Oxidum Hydratum, 


621 " » Ribs, 


449 


" Hemlock, 


615 


" " Nigrum, 


621^ " « Shoulder Blade, 


447 


" Sweet, 


656 


" Phosphas, 


622 
623 


" " Skull, 


445 


Gums, Inflammation of. 


398 


'' et Potassae Tartras, 


" Thigh Bone, 
*' *' Upper Arm Bone 
« " Wrist, 


450 


Gunshot Wounds, 


440 


" Protoxidum, 


622 


,447 


Gymnastics, 


91 


" Pulvis, 


622 


449 






•• et Quinae Citras, 


621 


Freezing Mixtures, 


503 


Hasmastasis, 


615 


" Subcarbonas, 


622 


French Decimal Weights, 


587 


Hasmatocele, 


472 


;; Sulphas, 


623 


" Milk Porridge, 


580 


Haematoxylon Campechia- 




: " Syrupus lodidi. 


623 


Frost Bite, 


434 


num, 


627 


1 " Tinctura Chloridi, 


623 


Frostweed, 


612 


Hasmaturia, 


300 


j Ferrum, 


620 


Fumigation of infected places, 502 


Hair, Disorders of. 


150 


1 Ferunculus, 


431 


Fungus Hematoides, 


468 


Hair Cap Moss, 


616 


Fever, 


407 






Half Bath, 


633 


1 " and Ague, 


411 


Galbanum Plaster, Comp., 


677 


Hammamelis Virginica, 


661 


! " Bilious Remittent, 


409 


Galium Aparine, 


605 


Hand, Dislocation of Bones || 


" Congestive, 


410 


Gall Bladder, 


33 


of, 


459 


'' Intermittent, 


411 


'' Stones, 


266 


" Fractures of, 


449 


" "Lung, 


240 


Galls, 


613 


Hardback, 


616 


*' Pernicious Intermittent, 410 


" Comp. Ointment of, 


674 


Hardleaf Golden Rod, 


616 


" Refreshing Drinks in 


, 577 


Gamboge, 


613 


Haunch Bones, Fractures of. 


450 


" Typhoid, 


408 


Gangrene of Mouth, 


398 


Hazel, Witch, 


661 


" Lung, 


242 


Garget, 
Garlic, 


640 


Headaches, 


J S3 


Feverfew, 


611 


613 


Head, Affections of. 


572 


Fibrine, 


15 


" Syrup of. 


682 


" Bath, 


534 


Figwort, 
Filling Teeth, 


612 


Gastric Fever of Infancy, 


404 


" Water in, 


157 


500 


" Juice, 


62 


Hearing, Organs of. 


51 


Fingers, Fractures of. 


449 


Gastritis, 


267 


Heart, 


36 


Fire, Clothes Catching, 


494 


Gastrodyma, 


275 


" Diseases, 


244 


Fits, 


406 


Gaultheria Procumbens, 


661 


" Altered Sounds of. 


246 


Flag, Sweet, 


656 


Gelatine, 


15 


" Aneurismal Tumors of, 250 





INDEX. 


723 


i 


PAGE 


PAGE 1 




PAGB 


1 Heart, Atrophy of, 


251 


Ilvpophosphites, Comp. Syrup | 


Iron, Tartrate of, and Potassa 
" Tincture of Muriate of. 


^^B 


1 " Bone aiid Cartilage in 


251 


of. 


682 


623 


" Dilatation of Ventricle 


5 


Hvssop, 


619 


" Valerianate of. 


624 


of, 


248 


Hyssopus Officinalis, 


619 


Ischuria Ilenalis, 


301 


" Displacements of, 


259 


Hysteria, 


362 


Isinglass, 


624 


'• Enlargement of Ventri 


-246 


Hysterics, 


362 


" Jelly, 


597 


cles of, 


246 






Itch, 


139 


" Fattv Degenerations of, 250 


Ice Plant, 


619 


" Barbers' 


149 


" Mypiertropby and Dila- 




Iceland Moss, 


619 


" Jackson's, 


149 


tation of, 


249 


Ichthyocolla, 


624 


Itching, 


146 


" Impulse of, 


245 


Icteriis, 


205 


" of External Parts, 


368 


" Induration of, 


250 


Idiocy, 


176 


Ivy, American, 


691 


" Inflammation of, 


253 


Ignatia Amara, 
Ileum, 


654 


" Big, 


631 


" Inflammation of Lin 




32 


" Ground, 


615 


ing of, 


253 


Impetigo, 


142 


" Poisoning by, 


497 


" Neuralgia of. 


258 


Incised Wounds, 


43G 






" rercussjon of, 


246 


Incubus, 
Indian Corn, 


1S2 


Jackson's Itch, 


149 


" Polypus of, 


259 


78 


Jalap, 


624 


« Shrinking of, 


251 


'; Hemp, 


619 


" Comp. Powder of. 


681 


« Softening of, 


250 


" " Tinct. of. 


687 


Jamestown Weed, 


654 


" Sounds of, 


245 


" Turnip, 


619 


Janipha Manihot, 


657 


" Valves of, 


254 


Indigestion, 


269 


Jaundice, 


265 


Heartbufn, 


274 


Indigo, Wild, 


660 


Jaw, Fractures of Lower, 


446 


Heart-case, Acute Inflamma 


■ 


Infancy of Being, 
Infants, Gastric Feyer of. 


52 


" Dislocation of " 


456 


tion of, 


251 


404 


Jejunum, 


32 


*' Chronicluflamma 




" Milk for, 


578 


Jelly, Calf's-Feet, 


681 


tion of, 


"252 


" Summer Complaints of, 402 


" Irish Moss, 


579 


" Water in, 


257 


Inflammation, 


423 


» Isinglass, 


679 


Hedeoma Tulegioides, 


636 


Inflammatory Blush, 


138 


'« Tapioca, 


579 


Heliauthemum C'anadense, 


612 


Influenza, 


205 


Jerusalem Oak. 
Jessamine, Yellow, 


662 


Helianthus Anuuus, 


655 


Infusion of Malt, 


677 


662 


Hellebore, White, 


659 


Infusions, 58? 


,668 


Joints, 


25 


Helonias, 


616 


Inhalants, 


221 


" Diseases of. 


664 


" Dioica, 


616 


Objects of, 


223 


" False, 


445 


Hemicrauia, 


172 


Inhalation, Atmospheric, 


227 


Juglandin, 


600 


Hemiphlegia, 


162 


Inhaler, Medicated Vapor, 


223 


Juglans Cinerea, 


600 


Hemlock, Comp. Tinct. of, 


689 


Inhaling Powder, 


680 


Juniper, 


624 


" Gum, 


615 


Injections, 548 


,669 


Juniperis Communis, 


624 


Hemorrhoids, 


285 


Injections, Chemical, 


433 


Juniperus Sabina, 


647 


Henbane, 


616 


" Mechanical, 


435 






Hepar, 


613 


Insanity, 


173 


Kalmia Angustifolia, 


631 


Hepatica Americana, 


626 


Causes of, 


177 


Latifolia, 


631 


Hernia, 


474 


" On one Subject, 


175 


Kidneys, 


34 


Herpes, 


139 


Instrument, Tonsil, 


202 


'' Acute Inflammation 1 1 


Hiccough, 


180 


Interalgia, 


280 


of. 


292 


High Cranberry, 


617 


Intermarriages, 


57 


" Chronic Inflamma 


. 


" Comp Tinct. of, 689 


Intermittent Fever, 


411 


tion of. 


294 


Hip Joint, Disease of, 


464 


Intestines, 


32 


" Bleeding from, 


300 


'• " Dislocation of, 


459 


Introduction, 


5 


" Bright's Disease of. 


297 


Hippuric Acid iu Urine, 


311 


Inula Helenium, 


611 


King'sEvil, 


417 


Homoeopathy, 


y 


Iodide Potassium, 


620 


Kino, 


624 


Homoeopathic Remedies, 


506 


Iodine, 


620 


" Comp. Powder of. 


681 


Hooping Cough, 


401 


lodinum. 


620 


Knee Joint, Dislocation of, 


406 


Hops, 


617 


Ipecacuanha, 


620 


" Pan, " " 


461 


Hordeolum, 


479 


" Comp. Powder of, 681 


" « Fractures of. 


452 


Horehound, 

Water, 


617 

658 


Syrup of, 
" Wine of. 


683 
671 


Krameria Triandra, 


645 


Horsemint, 


618 


Ipomoea Jalapa, 


624 


Labor, 


379 


Horseradish, 


618 


Iridin, 


598 


Labyrinth, 


51 


Hose Bath, 


532 


Iris, 


49 


Lacerated Wounds, 


439 


Hot Drops, 
Houseleek, 


690 
618 


" Inflammation of, 
" Versicola, 


483 
598 


Lachrymal Canals, 
Glands, 


50 
50 


Humid Tetter, 


139 


Irish Moss, Jelly of. 


579 


" Sac, Inflammation 1 1 


Humulus Lupulus, 


617 


Iritis, 


483 


of, 


480 


Huxham's Tincture, 


690 


Iron, 


620 


Lac teals. 


32 


Hydatids Uterine, 


364 


" Ammonio-Citrate of, 


621 


Lactuca Sativa, 


625 


Hydrangea, 


618 


" Black Oxide of. 


621 


Ladies' Slipper, 624, 663 1 1 


" Aborescens, 


618 


" Citrate of, 


621 


Lappa Minor, 


600 


Hydrargyri Chloridum Mite 


600 


" " " and Quinia, 


621 


Laryngeal Shower Syringe, 


185 


PilluliE, 


598 


" " *' " Strychnia, 621 


Laryngismus Stridulus, 


400 


Hydrastin, Comp. Powder of, 680 


" Comp. Mixture of. 


672 


Laryngitis, Follicular, 


192 


Hydrastis Canadensis, 


614 


" Hydrated Oxide of. 


621 


Larynx, 

" Inflammation of, 


40 


Hydriodate Potaesa, 


620 


" Iodide of. 


621 


192 


Hydrocele, 


471 


«' Lactate of, 


621 


Laudanum, 


687 


Hydropathy, 


6 


" Per Salt of. 


622 


" Poisoning by, 
Laurel, Narrow Leal; 


497 


Hydropathic Treatment, 


526 


" Phosphate of, 
" Powder of. 


622 


631 


Hydropericardium, 


257 


622 


" Sheep, 
Laurus Sassafras, 


631 


Hydrophobia, 


165 


« Precipitated Carbonate 


647 


Hydrocephalus, Acute, 


157 


of. 


622 


Lavender, Comp. Tinct. of. 


690 


" Chronic, 


158 


" Protoxide of, 


622 


Lead, 


625 


Hydrothorax, 


237 


" Solutions of Protoxide 


" Acetate of, 


625 


Hygiene, 


52 


of. 


622 


" Ointment, Comp., 


676 


Hyoscyamus Niger, 

" Poisoning by, 


616 


" Sulphate of. 


623 


» Palsy, 


164 


497 


" Syrup of Iodide of. 


623 


" Pipes, 


87 


Hppertrophy of Luugs, 


235 


*' Syrup of Iodide of, an 


i 


" Plaster, 


678 


Hypochondria, 


179 


Manganese, 


623 


" '' Comp., 


677 



724 


INDEX. 








PAGE 1 


PAGE 




PAGE 


Leaders, Conservative, 


11 Masturbation, 


334 


Muscles, Shape of, 
Mustard, 


27 


Leg Bath, 


SSI Materia Medica, 


584 


631 


" Fractures of, 


453 


Matico, 


630 


" Volatile Oil of, 


631 


Lemon, 


625 


Mattery Pimples, 
Meadow Cabbage, 


142 


Myrica Cerilera, 


594 


" Syrup, 


683 


649 


Myricin, 


594 


" Water, 


577 


" Saffron, 


630 


Myristica Moschata, 


633 


Lemonade, 
Lenitive Electuary, 


578 


Measles, 


131 


Myrospernum Toluiferum, 


593 


666 


" False, 


138 


Myrrh, 


632 


Leonurus Cardiaca, 


630 


Measures, 


585 


" Comp. Tinct. of, 


690 


Leopard's Bane, 


592 


" Domestic, 


587 






Lepra, 


143 


Meats, 


77 


Naptha. 


632 


Leprosy, 


143 


Meatus Auditorius, 


51 


Napthaline, 


632 


Leptandra Virginica, 


609 


" Inflammation of. 


487 


Nasal Catarrh, 


189 


Lettuce, 


625 


Mechanical Injuries, 


435 


" Duct, 


50 


Leucorrhoea, 


351 


Medicated Waters, 


670 


" Shower Syringe, 


196 


Liberality, 


10 


'• Wines, 


671 


Necrosis, 


463 


Lichen, 


144 


Medicine, Progress of. 


5-9 


Nepeta Cataria, 


602 


Life, 


52 


" Chest, Articles for 


, 585 


" Glechoma, 


615 


" Boot, 


625 


Medicines, 


584 


Nephritis, 


292 


Lily, Wnite Pond, 


659 


Medulla Oblongata, 


45 


Nerve Root, 


663 


Lime, 


626 


Melancholy, 


174 


Nerves, Cranial, 


45 


" Chloride of, 


626 


Melanosis, 


468 


' ' Diseases of Braip and 


,152 


" Water, 


626 


Melissa Officinalis, 


692 


" Optic, 


48 


Liniments, 


669 


Meuispermum Canadense, 


663 


" Pain in. 


171 


Liniment of Ammonia, Comp 


). 669 


Menorrhagia, 
Menses, Absence of. 


354 


" of Skin, Disordered, 


146 


" Camphor, 


669 


352 


" Lymphatic, 


47 


" Camphorated Soap 


670 


" Cessation of. 


360 


Nervous Disease, 


60 


*' Comp. Camphor, 


669 


Menstruation, 


338 


" System, 44-52 || 


! " Croton Oil, 


670 


Painful, 


355 


" " Sympathetic 


, 60 


" of Opium, 


670 


" Profuse, 


354 


Nettle Rash, 


137 


Linum Usitatissimum, 


612 


Mentha Piperita, 


636 


Neuralgia, 


171 


Liquidamber Styraciflua, 
Liquor Ammoniae, 


656 


" Virides, 


652 


" of Heart, 


258 


591 


Mesenteric Disease, 


405 


Neutral Mixture, 


642 


" " Acetatis, 


592 


Metritis, 


365 


Neutralizing Cordial, 


685 


Liquorice, 


626 


Mettauer's Aperient, 
Micotianum Tabacum, 


673 


» Extract, 


672 


Liriodeudron Tulipifera, 


657 


656 


Powder, 


681 


Liver, 


33 


Midwifery, 


375 


Nevus, 

New Jersey Tea, 


146 


" Acute Inflammation of, 262 


Milk, 


74 


645 


" Chronic " " 


263 


" Coffee, 


583 


Nightmare, 


182 


" of Sulphur, 


643 


" for Infants, 


578 


Nitrate of Mercury Ointment 


,674 


Liverwort, 


626 


" Leg, 


385 


" of Potassa, 


633 


Lobelia, 

'• Inflata, 


626 


'< Porridge, 


579 


'' , '• Poisoning by 


,496 


626 


" Sickness, 


276 


" of Silver, 


632 


« Tinct. of. 


687 


" and Soda Water, 


582 


Nitre, 


633 


" Comp. Tinct. of, 

" and Capsicum, Comp 


690 


Milkweed, Swamp, 


655 


" Sweet Spirit of, 63£ 
Nitric Acid, Poisoning by, 


,652 




Mind, Derangement of, 


173 


496 


Tinct. of, 
" Vinegar of, 


* 690 


Mindererus, Spirit of. 


592 


" Ether, Spirit of, 


652 


691 


Miscarriage, 


378 


Nose Bath, 


538 


Lohelin, 


627 


Miscellaneous, 


692 


" Bleeding from. 


489 


Local Palsy, 


163 


Mitchell a Repens, 


635 


" Foreign Substances in. 


490 


Locked Jaw, 


166 


Mitral Valves, Diseases of. 


255 


" Fractures of. 


445 


Logwood, 


627 


Mixtures, 


672 


Nurse, 


555 


Looseness of Bowels, 287 


,401 


Modus Operandi of Water, 


544 


'• Activity of, 


557 


Lumbar Plexus, 


47 


Momordica Elaterium, 


660 


" Age of, 

" Education of, 


555 


! Lung Fever, 


240 


Monarda Punctata, 


618 


557 


Lungs, 


35 


Monkshood, 


661 


" Habits of, 
" Health of. 


557 


" Hypertrophy of. 


235 


Monk's Hood, 


630 


556 


" Swelling of, 


235 


Monomania, 


175 


" Strength of, 


555 


Lupulin, 


618 


Monotropa Uniflora, 


619 


" Temper, etc., of, 


556 


LupuSj 


144 


M ousel's Styptic, 


622 


Nursing Sore Mouth, 


386 


Luxations, 


455 


Morphia, 


635 


Nutmeg, 


633 


Lycopus Virginicus, 
Lye, Poisoning by, 


600 


Acetate of; 
" Muriate of, 


635 


Nutrition Table, 


f' 


496 


635 


Nutritive Fluid, 


5^3 


Lymphatics, 


38 


" Sulphate of. 


635 


Nux Vomica, 


633 


Lypemania, 


174 


" Valerianate of. 


635 






1 




Morphine, 


635 


Oak, White, 


659 


Maculae/ 


146 


" Poisoning by. 


497 


Oats, 


77 


Magnesia, 


627 


Mortification, 


428 


Oil Glands, Disordered, 


148 


" Carbonate of. 


628 


Motlier's Cordial, 


684 


" of Cajeput, 


633 


1 '* Sulphate of. 


628 


" Marks, 


146 


" of Turpentine, 


634 


" Usta, 


627 


Motherwort, 


630 


Ointments, 


673 


Magnesiae Carbonas, 


628 


Mountain Laurel, 


631 


Olea Europeae, 


634 


" Sulphas, 


628 


Mouth or Oral Bath, 


539 


Oleum Cajuputi, 


633 


Male Fern, 


628 


" Infiammation of. 


396 


" 3Iorrhuae, 


605 


Malignant Pustule, 


432 


" Follicular luflamma 


. 


" Olivje, 


634 


Malt, Infusion of, 


577 


tion of, 


397 


" Ricini, 


602 


j Mammary Abscess, 


386 


" Grangrene of. 


398 


" Terebinthinae, 


634 


1 Mandrake, 


628 


Mucus, 


15 


" Tiglii, 


609 


i Mania, 


175 


Mullein, 


631 


Olive Oil, 


634 


1 '' a Potu, 


155 


Mumps, 


207 


Omentum, 


34 


1 Manna, 


628 


3Iuriate of Soda, 


651 


Onanism, 


334 


Maranta Arundinacia, 


592 


Muriatic Acid, Poisoning by 


496 


Oiie Idea Men, 


5 


Marshmallow, 


629 


Muscae Volitantes, 


483 


Onion, 


634 


Mai-sh Rosemary, 


629 


Muscles, 


27 


Ophthalmia Catarrhal, 


482 


Marubium Vulgare, 


617 


" Action of. 


29 


" Egyptian, 


480 


Mastich, 

1 


629 


". K umber of, 


28 


" Purulent, 


480 





INDEX. 




725 




PAGE 


PAGE 




PAGE 


Ophthalmia of Children, 


4S1 Pharynx, 

482 " Inflammation of, 


31 


Potassae, Citratis, Liquor, 


642 


•• Scrofulous, 


191 


" Liquor, 


642 


" Tarsi, 


479 Phlebitis, 


472 


" Nitras, 


633 


Opium, 


634 " Chronic, 


473 


" Sulphas, 
" Tartras, 


64^ 


*• Camphorated Tinct. of, 690 Phle^rmasia Dolens, 


385 


642 


'• Liniment, 


670 


Phosphates, Comp. Svrup of 


684 


Potassii Bromidum, 


642 


" Poisoning by, 


497 


Phosphatic Deposits in Urine, 308 


" Cyanuretum, 


643 


'^ Tiuct. of, 


6S7 


Phosphorus, 224, 638 


" lodidum, 


620 


Opodeldoc, 


670 


Phrenitis, 


153 


" Sulphuretum, 


643 


Orange Peel, 


635 


Phthisis, 


209 


Potassium, 


642 


'• Tinct. of. 


687 


Physical Development, 


91 


" Bromide of, 


642 


Orbits, 


50 


1 Physician, True, 


12 


" Cyanuret of, 
" Sulphuret of, 


643 


Orchitis, 


331 


1 Physiological Laws, 


52 


643 


Origanum, 


635 


Physiologists, 


8 


Potatoes, 


79 


Yulgare, 


635 


Phytolacca Decandra, 


640 


Poultices, 


678 


Ornus Europ:ea, 


628 


Phytolaccin, 


640 


Powders, 


679 


Osmunda Kegalis, 


599 


Pia Mater, 


45 


Pox, 


318 


Otalgia, 


488 


" " Inflammation of. 


153 


Prejudices, 


558 


Otitis. 
Otorrhoea, 


488 


Picn-ena Excelsa, 


644 


Preparations, 


664 


487 


Pigeon -berry. 


640 


" of Medicine, 


584 


Ovaries, Inflammation of. 


348 


Pile Ointment, 


675 


Prepared Calamine, 


664 


Ovaritis, 


348 


Piles, 


285 


" Chalk, 


603 


Ox lie Acid, Poisoning by. 


496 


Pills, 


676 


Prickly Ash, 


643 


Deposits in Urine, 
Oxide of Zinc Ointment, 


309 


Pimpinella Anisum, 


592 


" Elder, 


643 


674 


Pimples, Drv, 


144 


Prince's Pine, 


639 






Mattery, 


142 


Prinos Verticillatus, 


596 


Pack, Half, . 


528 


" Watery, 


138 


Prognostics, 


559 


" Wet Sheet, 


526 


Pink Root, 


638 


Prolapsus Ani, 


403 


Pail Douche, 


5.32 


Pinna, 


51 


Uteri, 


366 


Painters Colic, 


283 


Piper Angustifolium, 


630 


Pronouncing Dictionary, 


715 


Palpitation, 


257 


Pipsissewa, 


639 


Prunus Virgiuiana, 


659 


Palsv, 


162 


Pistacia Lentiscus, 


629 


Prurigo, 


144 


" ' Lead, 


164 


Pitvriasis, 


143 


" of Vulva, 


368 


" Local, 


163 


Pix Liquida, 


656 


Pruritis, 


146 


" Shaking, 


164 


Plantago Major, 


639 


Prussic Acid, Poisoning by. 


497 


Panada, 


578 


Plantain, 


639 


Psoriasis, 


143 


Panax Quinquefolium, 


614 


Plasters, 


676 


Ptelia Trifoliata, 


649 


Pancreas, 

Papaver Somniferum, 


33 
634 


Pleurisy, 

" Eoot, 


238 
639 


Ptercorpus Marsupium, 
" Santalmus, 


624 
645 


Papulous Seal!, 


142 


Pleuritis, 


238 


Ptisan, Suet, 


581 


Populus Candicans, 


593 


Plumbi Acetas, 


625 


Ptosis, 


480 


Paracentesic Instrument, 


504 


Plumbum, 


625 


Puerperal Fever, 


385 


Paralysis, 


162 


Plunge Bath, 


534 


Pumpkin Seed, 


644 


Paraphlegia, 


163 


Pneumonia, 

" Typhoid, 


240 


Punctured Wounds, 


439 


Paregoric Elixir, 
Parrilla, Yellow, 


690 


242 


Purple Disease, 


421 


663 


Pneumothorax, 


236 


Purpura Hemorrhagica, 


421 


Paronychia, 


465 


I'odophyllum Pellatum, 


628 


Purtussis, 


401 


Parotitis, 


207 


Poison Oak, 


640 


Purulent Ophthalmia, 


480 


Parsley, 


635 


" Hemlock, 


638 


" " ofChildrer 


,481 


Parsnips, 
Partridge Berry, 


79 


" " Ointment, 


674 


Pyrethium Parthenium, 


611 


635 


Poisoned Wounds, 


440 


Pyrola Rotundifolium, 


646 


" " Comp. Syrup 


Poisoning Accidents, 


494 


" Round Leaved, 


646 


of. 


684 


Poisons, Antidotes of, 


494 


Pyrosis, 


275 


Patches, Colored, 


146 


" Vegetable, 


496 






Patella, Dislocation of, 


461 


Poke, 


640 


Quassia, 


644 


" Fracture of, 


452 


" Ointment, 


674 


Queen of the Meadow, 


644 


Patients, How to Examine, 


122 


Polygala Senega, 


648 


Queen's Root, 


644 


Peach, 

Pear Leaf Wintergreen, 


636 


Polygonum Punctatum, 


659 


Quercus Alba, 


659 


646 


Polypus, 


469 


" Infectoria, 


613 


Pearlash, Purified, 


641 


" of Heart, 


259 


Quinia, Sulphate of, 


637 


Peas, 


79 


» of Womb, 


303 


" Valerianate of, 


637 


Pediluvium, 


538 


Polvtrichum Juniperum, 


616 






Pelvis, Fractures of, 


450 


Pompholix, 


141 


Rabies, 


165 


Pemphigus, 


141 


Poplar, 


657 


Ramollissement, 


154 


Pemiyroyal 
Pepper, Water, 


636 


Porridge, Milk, 


579 


Rectum, 


32 


659 


" French Milk, 


580 


Red Chickweed, 


645 


Peppermint, 


636 


Porrigo, 


150 


'' Clover, 


645 


Pericarditis, 


251 


Potassa, 


640 


*' Iodide of Mercury Oint 




Peritoneum, Acute Inflamma 


- 


" Acetate of, 


641 


ment, 


' 674 


tion of, 


277 


" Bicarbonate of, 


641 


" Pepper, 


603 


" Chronic Inflam 


- 


" Bitartrate of, 


641 


" Oxide of Lead Plaster, 


678 


matipn of, 


278 


" Carbonate of. 


641 


" Ozier, 


655 


Peritonitis, 


277 


« Chlorate of. 


641 


" Root, 


645 


Pernicious Intermittent Fe 




" Citrate of. 


642 


" Rose, 


645 


ver. 


410 


" " Solution of, 


642 


" Saunders, 


645 


Persimmon, 


637 


" Solution of, 


642 


" Willow, 


655 


Perspiration, 


102 


" " " Arsenite of, 651 1 


Refreshing Drinks in Fevers, 


577 


Perspiratory Tubes, 


102 


" and Soda, Tartrate ol 


-,651 


Reproduction of Lost Parts, 


440 


Peruvian Bark, 


6S7 


" Sulphate of, 


642 


Resin Plaster, Comp., 


677 


" Tinct. of. 


690 


" Tartrate of, 


642 


Respiratory Organs, 


35 


Petrolium, 


638 


Potassae, Acetas, 


641 


Rest and Sleep, 
Restorative Wine Bitters, 


95 


Petroselinum Sativum, 


635 


" Arsenitis, Liquor, 


651 


671 


Pharmacy, 


664 


" Bicarbonas, 


641 


Restoratives, 


582 


Pharyngeal Shower Syringe, 


196 


" Bitartras, 


641 


Retention of Urine, 


302 


Pharyngitis, 


191 


" Carbonas, 


641 


Retina, 


49 


Follicular. 


191 


» Citras, 


642* 


Rhamnus Catharticus. 


599 



726 


INDEX. 






PAGE PAGE 1 


PAGE 


Ehatany, 


654 


Scrofula, 417 


Small Spikenard, 
Smart Weed, 


650 


Rheum Palmatum, 


646 


Scrofulous Ophthalmia, 482 


659 


Rheumatism, Acute, 


414 


Scrophularia Nodosa, 612 


Smilax Officinalis, 


647 


Chronic, 


415 


Scrotum, Blood in, 472 


Snake Root, 
Snakeroot, Virginia, 


648 


Rhubarb, 


646 


Water in, 471 


658 


" Aromatic Syrup of, 


682 


Scullcap, 648 


Soap, 


650 


« Comp. Tinct. of, 


691 


Scurvy, 419 
Scutellaria Laterifolia, 648 


Soda, Bicarbonate of. 


650 


" " Powder of, 


681 


" Borate, 


650 


" and Potassa, Comp 
Powder of, 




Sea Bathing, 542 


" Sulphate of, 


651 


' 681 


Seasickness, 276 


» Sulphite of, 


651 


" and Potassa, Comp 




Secale Cornutura, 653 


Sodae, Bicarbonas, 


650 


Syrup of. 


685 


Secretion, Organs of, 40 


" Boras, 


650 


« Sweet Tinct. of, 


691 


Seidlitz Powders, 651 


" et Potassae Tartras, 


651 


«' Syrup of, 


682 


Self Pollution, 334 


" Sulphas, 


651 


" Tinct. of, 


688 


Semilunar Valves, Disease of, 254 


" Sulphis, 


651 


Rhus Glabrum, 


655 


Sempervirum Tectorum, 618 


Sodii Chloridum, 


651 


" Toxicodendron, 


640 


Seneca Oil, 638 


Sodium. 


650 


Ribs, Fracture of, 


449 


Senecin, 625 


" Chloride of, 


651 


Rice, 


78 


Senecio Aureus, 625 


Solanum Dulcamara, 


695 


" Gruel, 


578 


Seneka, 648 


Solidago Rigida, 


616 


Ricinus Communis, 


602 


" Syrup of, 683 


Solomon's Seal, 


651 


Rickets, 


405 


Senna, 648 


Soluble Tartar, 


642 


Ringworm, 
Rochelle Salts, 


151 


" and Jalap, Tinct, of, 691 


Sore Nipples, 
Soup, Vegetable, 


387 


651 


Sensations, 54 


680 


Rosa Gallica, 


645 


" Agreeable, 55 


Spanish Flies, 


652 


Rose Rash, 


138 


" Unpleasant, 56 


" " Liniment, 


670 


" Red, 


645 


Sexual Diseases, 318 


" " Poisoning by, 


497 


«' Water Ointment, 


675 


" " Prevention of, 333 


Spasm of Glottis, 


400 


« Willow, 


655 


Shaking Palsy, 164 
Sheep Laurel 631 


Spearmint, 


652 


Rosemary, 


646 


Speculum, 


343 


Roseola, 


138 


Shingles, 139 


Spermaceti. 


652 


Rosemarinus Officinalis, 


646 


Shoulder Blade, Fractures of, 447 
" J oint. Dislocation of, 457 


" Ointment, 


675 


Rotting of Teeth, 


498 


Spice Plaster, Comp., 


677 


Round Leaved Pyrola, 


646 


Shower Bath, 532 


Spider's Web, 
Spigelia Marilandica. 
Spikenard, Small, 


652 


Rubbing Wet Sheet, 


529 


Shrubby Trefoil, 649 


638 


Rubeola, 


131 


Sick, Care of, 65 


650 


Rubus Villosus, 


596 


" Children, Nursing, 392 
« Room, Choice of, 549 


Spinal Cord, 


46 


Rudbeckia Laciniata, 


656 


" " Diseases of, 


159 


Rue, 


646 


" " Cleanliness in, 653 


" " Inflammation of 


159 


Rules for Using Water, 


546 


" " Cookery for, 576 


Spinal Nerves, 


46 


Rumex Crispus, 


662 


" " Darknenin- of, 554 
" " Domestic Manage- 


Spine, Deformities of, 


476 


Running and Leaping, 


90 


Spirit of Nitric Ether, 


652 


Rupia, 


141 


ment of, 649 


Spiritus ^theris Nitrici, 63S 


,652 


Rupture, 


474 


" " No Cooking in, 550 


" Ammoniae Aromaticus 


,592 


Ruptures of Tendons, 


463 


" " Prejudices and An- 


Spiroea Tomentosa, 


616 


Ruta Graveolus, 


646 


tipathies in, 558 


Spleen, 


54 


Rye, 
" Spurred, 


78 


« « Sofa or Easy Chair 


" Acute Inflammation of, 264 1 1 


653 


in, 650 


" Chronic " ' 


264 






" " Temperature of, 553 


Splenitis, 


264 


Sacral Plexus, 


47 


" « Unhired Attend- 


Sponge, 


653 


SaflFron, 


646 


ants in, 557 


Spongia, 


653 


'T'r.^ 


647 


Sight, Organs of, 48 


Sprains, 
Spurred Rye, 


462 


676 


" Long and Short, 484 


653 


Sago Gruel, 


579 


«' Weakness of, 483 


Squill, 


653 


Saint Ignatius'8 Bean, 


654 


Silex Alba, 661 


" Syrup of. 


683 


Sal Ammoniac, 


591 


Simple Ointment, 675 
" Syrup, 682 


" Vinegar of. 


691 


Salep Powders, Comp., 
Saline Mixture, 645 


578 


Squinting, 


485 


J, 673 


Sinapis Alba, 631 


Squirting Cucumber, 


660 


Salix Nigra, 


597 


Singultus, 180 


St. Anthony's Fire, 


136 


Salt, 


651 


Sippets, 576 


St. Ignatius's Bean, 


654 


" of Tartar, 


641 


Sitz Bath, 535 


St. Vitus's Dance, 


169 


Saltpetre, 

" Poisoning by, 


633 


Skin, 42 


Stagger Weed, 


657 


496 


" Color of. Disordered, 146 


Star Grass, 


653 


Salvia Officinalis, 


647 


" Diseases, 130 


Statici Caroliniana, 


629 


Sambucus Canadensis, 


611 


" Nerves of, Disordered, 146 


Sterility, 


• 369 


Sanguinaria Canadensis, 


597 


" Offices of, 102 


" Causes of. 


372 


Sanguinarin, 


597 


Skull, Fractures of, 445 


Stiff Joint, 


4u6 


Sapo, 


650 


Skunk Cabbage, 649 


Stillingia Sylvaticus, 


644 


Sarsapanlla, 


647 


Sleep, 95 


" Gomp. Syrup of, 


685 


" Comp. Syrup of, 685 


" Amount of, 97 


Stomach, 


32 


" False, 


650 


» Disturbed, 182 


" Affections of, 


674 


« Wild, 


650 


« Natural Position for, 97 


" Bile in. 


64 1 


Sassafras, 


647 


" Preparation for, 97 


" Acute Inflammation | j 


Savin, 


647 


Sleeping Apartment, 549 


of, 


267 


Scabies, 


139 


" Rooms, 95 


" Chronic Inflamma- 1 1 


Scalds, 

Scaly Eruptions, 


433 


" " Bedding in, 96 


tion of, 


268 


143 


" « Beds in, 96 


" Movement of. 


63 


Scammony, 


648 


» " Fire in, 95 
« « Night Dress in, 97 


«' Pipe, 


31 


Scarification, 


440 


" Spasm or Cramp in 


, 275 


Scarlatina, 


132 


« " Open Fireplace 


Stone in Bladder, 


313 


Scarlet Fever, 


132 


in, 96 


Storax, 


654 


Sciatica, 


173 


" " Open Windows 


Strabismus, 


485 


Scilla Maritima, 


653 


in, 96 


Stramonium, 


654 


Sclerotic Coat, 


48 


" " Small, 109 


" Ointment, 


675 


Scoke, 


640 


Slippery Elm, 650 


" Poisoning by, 


497 


Scorbutus, 


419 


Small Pox, 134 


Strychnine, Poisoning by. 


497 





INDEX. 


727 




PAGE 


PAGE 




PAGE 


Strvchnos Xux Vomica, 


633 


Throat Diseases, Instruments 




Varicocele, 


476 


Stye. 


479 


for Treatment of. 


195 


Variola, 


134 


St'vrax Officinale, 


654 


Tic Douloureux, 


172 


Varioloid, 


135 


Sudorific Tiuct., 


691 


Tight Dressing, 101 


,111 


Varix, 


473 


Suet Ptisau, 


5S1 


Tinctures, 588 


,686 


Vegetable Poisons, 


496 


Su^ar of Lead, Poisoning by, 496 


Tissues, 


16 


'' Soup, 


580 


'' of Milk, 


226 


Tobacco, 


656 


Veins, 


37 


Sulphur, 


654 


Toe Nail, Ingrowing, 


489 


" Acute Inflammation of. 


472 


Ointment, Comp., 


676 


Tolu, Syrup of. 


684 


" Enlarged or Varicose, 


473 


Sulphuric Acid, Poisoning bj 


,496 


'• Tiuct. of, 


688 


Venereal Diseases, 


318 


Sumach, 


655 


Tonsil Instrument, 


202 


Ventilation, 57, 108 


,551 


Summer Complaint of Infants, 402 


Tonsils, Acute Inflammation 




" in Sick Room, 


no 


Sunflower, 


655 


of, 


201 


Ventricles, 


36 


Sunstroke, 


162 


" Chronic Inflamma 




" Dilatation of. 


248 


Super Carbonate of Soda, 


650 


tion of. 


202 


" Enlargement of, 


246 


" Tartrate of Potassa, 


641 


Toothache, 


499 


Veratrin, 


590 


Suppression of Urine, 


301 


" Tree, 


643 


Veratrum Album, 


659 


Suppuration, 


427 


Towel and Sponge Bath, 


536 


Viride, 


690 


Supra Kenal Capsules, Disease 


Tracheitis, 


193 


Vervain, 


657 


of. 


296 


Trailing Arbutus, 


656 


Verbascum Thapsus, 


631 


Surgical Diseases, 


423 


Trance, 


168 


A'erbena Hastata, 


657 


Swamp Dogwood, 
" Milkweed, 


655 


Travelling, 112 


,230 


Verdigris, Poisoning by. 


495 


655 


'' Seasons for, 


113 


Vermes, 


291 


Sweat Glands, Disordered, 


46 


Trees. Cultivation of. 


110 


Verruca, 


145 


Sweet Fern, 


655 


Trefoil. Shrubby, 


649 


Vertigo, 


181 


" 1^1 ag. 


656 


Trifolium Pratense, 


645 


Vessels, Absorbent, 


38 


" Gum,- 


656 


Trillium Pendulum, 


595 


Viburnum Opulus, 


617 


" Oil, 


634 


Trumpet Weed, 


644 


Vinegar, 


658 


" Spirits of Nitre, 633, 652 


Tulip Tree, 


657 


Vinegars, 


691 


Swelling of Lungs, 


235 


Tumeric, 


657 


Virginia Snakeroot, 


658 


Sycosis, 


149 


Tumors, 


466 


" " Comp. Tinct 




Sympathetic Nervous System 


, 60 


" Encysted 


469 


of, 


* 691 


Symphytum Otlicinale, 


606 


" Fatty, 


469 


" " Tinct. of. 


688 


Symplocarpus Foetidus, 


649 


Turkey Corn, 


657 


Vision , Imperfect, 
Vocal Cords, 


484 


Symptoms, Table of, 


122 


Turner's Cerate, 


665 


41 


Syncope, 


181 


Turnips, 


79 


" Organs, 


40 


Synovial Degenerations, 


464 


Turpentine Liniment, 


670 


Vomiting, 


275 


Syphilis, 


318 


Tussilago Farfara, 


606 






Syringe, Laryngeal Shower, 


195 


Tylosis, 


145 


Wafer Ash, 


649 


» Nasal '' 


196 


Tvmpanitis, 


281 


Wahoo, 


659 


" Pharyngeal " 


196 


Tympanum, 

" Inflammation of. 


51 


Walking, 


90 


Syrups, 


681 


488 


Warts, 


145 






Typhoid Fever, 


408 


Wash Down, 


537 


Tag Alder, 


656 


" Lung Fever, 


242 


" Tub, 


535 


Tamarac, Comp. Tinct, of. 


691 


" Pneumonia, 


242 


Water, 


85 


Tauasetum Vulgara, 


656 






" Accidents on, 


494 


Tansy, 


656 


Ulceration and Ulcers, 


429 


" Apple, 


679 


Tapioca, 


657 


" of Bones, 


403 


" Barley, 


576 


" Jelly, 


579 


Unhired Attendants, 


557 


" Brash, 


275 


Tar, 


656 


Unicorn Hoot, 


653 


" Camphor, 


671 


" Ointment, 


675 


Union by First Intention, 


437 


» Chemical Nature of, 


86 


" Plaster, Comp., 


678 


Unnatural Growth of Bones, 


463 


" in Chest, 


237 


Taraxacum, 


610 


Upland Cranberry, 


593 


" Chicken, 


581 


Tea and Coffee, 


84 


Upper Arm Bone, Fractures 




" Cochituate, 


87 


" Beef, 


580 


of, 


447 


" Division of, 


86 


" Sage, 


576 


Urate of Ammonia in Urine, 


310 


" Gruel, 


578 


■ Teeth, 


29 


Ureters, 


34 


" in Heart Case, 


257 


" Care of, 


498 


Urethra, 


35 


" Horehound, 


658 


" Cleaning of, 


501 


Uric Acid Gravel, 


306 


" Impure, 


88 


" Composition of, 
" Cutting, Difacult, 


30 


Urinary Deposits, 


304 


" Impurities in. 


86 


399 


" System, 


34 


" Lemon, 


577 


" Diseased, 


501 


Urine, Cystine Deposits in. 


312 


" Milk and Soda, 


582 


" Filling, 


500 


" Examination of. 


305 


" Modus Operandi of. 


544 


" First, 


501 


" Hippuric Acid Deposits 


" Pepper, 


659 


" Names of, 


30 


in, 


311 


" Properties of. 


87 


" Number of, 


29 


" Inability to hold, 
" Oxalic Deposits in, 


303 


" Rain, 


87 


" Origin of. 


29 


309 


" Rice, 


576 


" Hotting of. 


498 


" Phosphatic Deposits in 


,308 


" Rules for Using, 


646 


" Use of, 


30 


" Retention of, 


302 


" Salt, 


88 


Tela Aranese, 


652 


" Suppression of. 


301 


" in Scrotum, 


471 


Temperaments, 


118 


" Urate of Ammonia in 


310 


" Schuylkill and Croton 


, 87 


Abdominal, 


119 


Urticaria, 


137 


Waters, Medicated, 


670 


" Cephalic, 


118 


Uteri Prolapsus, 


366 


Watery Pimples, 


138 


" Medication and 


, 119 


Uterine Hydatids, 


364 


Wave or Sluice Bath, 


533 


" Muscular, 


119 


Uva Ursi, 


693 


Wax, 


659 


" Thoracic, 


119 


Uvula, Elongation of, 


200 


Weaning, 


390 


Temperature, 
Tendons, Ruptures of. 


553 






Wens, ^' 


469 


463 


Vaccina, 


136 


Weights, 

'' French Decimal, 


586 


Tetanus, 


166 


Vagina, Inflammation of, 
Valerian, 


367 


587 


Tetter, 


139 


657 


Wet Bandages, 


547 


" Crusted, 


142 


" Comp. Tinct. of. 


691 


" Dress, 


528 


" Humid, 


139 


Valeriana Oflicinalis, 


657 


" Sheet, Folded, 


529 


Thigh Bone, Fractures of, 


450 


Valves, Mitral, 


36 


» " Pack, 


526 


I Thimbleweed, 


656 


" Semilunar, 


36 


" " Rubbing, 


629 


Thornapple, 
Throat Diseases, 

j 


654 


" Tricuspid, 


36 


Wheat, 


77 


188 


Varicella, 


135 


" Flour, Unbolted, 


71 



728 



INDEX. 





PAGE 


Whey, Alum, 


581 


" Mustard, 


581 


" Orange, 


582 


" Keniiet, 


581 


« Sweet, 


582 


" Tartar, 


581 


«' Vinegar, 


581 


" With Tamarinds, 


582 


" Wine. 


582 


White Hellebore, 


659 



Ointment, 675 

" Indian Hemp, 655 

" Liquid Physic, 673 

" Oak, 659 

" Pond Lily, 659 

'' Poplar, 657 

" Swelling, 464 

" Vitriol, Poisoning by, 496 

Whites, 351 

Whitlow, 465 

Wild Cherry, 659 

'• Bark, Syrup of, 684 

Cucumber, 660 

Ginger, 660 

Indigo, 660 

" Ointment, 675 

Sarsaparilla, 650 

Snow Ball, 645 

Turkey Pea, 657 

Woodbine, 591 

Yam, 660 

Willow, 661 

Wind Colic, 280 



PAGE 

Windpipe, 35 

" Foreign Bodies in, 491 
" Inflammation of, 193 
Wine Bitters, Restorative, 671 
" of Comfrey, Corap., 671 
" of Golden Seal, Comp., 671 
" of Ijiecacuanha, 671 

Wines, Medicated, 671 

Wingseed, 649 

Wintergreen, 661 

Witch Hazel, 661 

Wolfsbane, 661 

Womb and Appendages, 341 

" Falling of, 366 

" " over of, 366 

" Inflammation of, 365 

" Inflammation ofNeck of, 344 
" Polypus of, 363 

Worm Powder, 681 

Worms, 291 

Wormseed, 662 

Wormwood, 662 

Wounds, Bleeding from, 491 

" Contused and Lacer- 
ated, 439 
" Derangements from, 166 
" Gunshot, 440 
" How to Unite, 438 
" Incised, 436 
" Poisoned, 440 
" Punctured, 439 
" Rules for Examin- 
ing and Dressing, 438 



Wrist, Dislocation of, 

" Fractures of, 
Wry Neck, 



453 
449 
478 



Xanthoxylum Fraxineum, 643 

Yam, Wild, 660 

Yarrow, 662 

Yeast, 662 

Yellow Dock, 662 

" " Comp. Syrup of, 686 

" Fever, 413 

" Jessamine, 662 

" Ladies' Slipper, 663 

" Parilla, 663 



Zinc, 

" Acetate of. 

" Chloride of, 

" Iodide of, 

" Oxide of, 

" Precipitated Carbonate 
of, 

" Sulphate of, 

" Valerianate of, 
Zinci Carbonas Praecipitas, 

" Chloridum, 

" lodidum, 

" Oxidum, 

" Sulphas, 

" Valerianas, 
Zingiber Officinale, 



663 
663 



664 
664 
664 
664 
663 
663 
663 
664 
664 
613 




-z^^^-^ 



THROAT, LUNG, HEART, 



AND OTHEK 



CHRONIC DISEASES TREATED 



DrRixG the last ten years, the author of this book has devoted himself to the study and 
management of the above-named diseases, and has treated several thousand cases from the 
different States of this Union, and from the British Provinces. I have no desire to make a 
display of it, but it should be stated that I was the first to use the present American System 
of Inhalation of medicinal substances for the cure of disorders of the chest, and published in 
the newspapers of Boston the first articles on the subject for popular reading. 
j Beside diseases of the Throat and Chest, my practice has extended to Female Complaints, 

Disorders of the Liver, Stomach, Kidneys, Genital Organs, and, indeed, to all Chronic Com- 
plaints of long standing, which have defied the usual remedies. 

Among the Instruments which I have had occasion to invent, the following are well known, 
and extensively used ; and may always be had of me, at the prices annexed : 

Warren's Shower Syringes, three in one case, Silver, . . $10 
The Same with Gold Tubes and Silver Barrel, .... 40 
The Same with Gold Tubes and Glass Barrel, ... 30 

Warren's Improved Tonsil Instrument, 10 

Warren's Powder Inhaler, 1 

Warren's Medicated- Vapor Inhaler, 1 

The following elegant Instrument, recently prepared by me, and described on pages 504 and 
505 of this book, is, I think, well worthy the attention of physicians and surgeons : 

Warren's Paracentesic Instrument, $30 

Patients who visit me from abroad, need not write to inquire when I can be seen, as I am in 
my oflice, every day, from 8 A. M. to 3 P. M., Sundays excepted. 

Those who cannot come to Boston, but wish to take my advice, etc., may do so by forward- 
ing a description of their case, prepared by their Physician; or, they may send to me, and I 
will furnish them a list of printed questions, which they may answer by letter. 

Such as visit me, and need to stay a few days or weeks in Boston, may always obtain board 
at from three to six dollars a week, according to the accommodations they may select. 

All sick persons, while from home, and in Boston under my care, are most tenderly watched 
over; and nothing is left undone which can tend to make their stay pleasant, and their recov- 
ery rapid. 

I have prepared a Medicine Chest, adapted to this book, for the use of Ships, Steamboats, 
Hotels, Plantations, etc., which may be ordered from me direct, and through the agents of the 
publishers. There are two sizes; the smaller is $25; the larger is $40. 

IRA ^VARREN, M. D. 

Boston, No. 3, Avon Place. 



RECOMMENDATIOIfS 



TV^^RREIST'S SYRINGES 



From the Boston Medical and Surgical Journal. 

"Throat Syringes. — Dr. Ira Warren is the inventor of several instruments for the appli- 
cation of medical remedies to the throat, which are not only quite new in pattern, but beautiful 
in workmanship. * * * The probang, and other contrivances heretofore resorted to, will 
be superseded by these ingenious instruments." 

From the Franklin County Medical Society. 

" Resolved, — That from an examination of Dr. Ira Warren's Laryngeal, Pharyngeal, and 
Nasal Shower Syringes, we think them well adapted for the purposes for which they were in- 
tended." 

From Henry J. Bigelow, M. D., Prof, of Surgery in Harvard University, and one of the Surgeons 
of the Massachusetts General Hospital. 

" Dr. Ira Warren's Syringes are excellent instruments for injecting caustic, and other fluids, 
into the fauces, trachea, and posterior nares. HENRY J. BIGELOW, M. D." 

From Drs. Gould, Morrill, and Clarke, Censors of the Massachusetts Medical Society. 

" I have, for some months past, made frequent use of the Shower Syringes, constructed 
under the direction of Dr. Ira Warren, and consider them a decided improvement upon all 
other instruments which are in use, for similar purposes. 

AUGUSTUS A. GOULD, M. D." 

" I concur most heartily with Dr. Gould in the opinion that Dr. Warren's Syringes are a 
valuable invention, easily used, not Hable to get out of order, and the only instruments, with 
which I am acquainted, by which caustic can be applied easily and eflTectually to the throat 
and posterior nares. S. MORRILL, M. D." 

" I consider the instruments of Dr. Warren to be a decided improvement over the sponge. 

ED. H. CLARKE, M. D." 

From Dr, Samud Kneeland, Jr., Demonstrator of Anatomy in Harvard University. 

"Every one who has had frequent occasions to introduce into the larynx the old probang 
and sponge, for the purpose of cauterization, with its attendant diflaculties and suffering, will 
hail the improvements of Dr. Ira Wai-ren's Shower Syringes as of great value. They render 
this disagreeable operation exceedingly easy, and comparatively free from pain. 

SAM'L KNEELAND, Jr., M. D." 






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